Active NPI
Joel C Dykstra, PT
- Orthopedic Physical Therapist
- Skokie, IL
National Provider Identifier
1912216847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 070.008745
- Practice address
- 9669 Kenton Ave
Skokie, IL 60076-1266 - Phone
- (847) 933-3810
- NPI assigned
- Sep 27, 2010
- Last updated
- Sep 27, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 070.008745 | IL | Primary |
Addresses
Primary practice location
9669 Kenton Ave
Skokie, IL 60076-1266
Mailing address
1821 Grant St
Evanston, IL 60201-2534
Phone (847) 492-8107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.008745 | IL | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1912216847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1821 GRANT ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602012534",
"telephone_number": "847-492-8107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9669 KENTON AVE",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761266",
"telephone_number": "847-933-3810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKSTRA",
"first_name": "JOEL",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-27",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "IL",
"license": "070.008745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.