Individual provider Active NPI

Carol J Humble, MS ATC

  • Athletic Trainer
  • Glen Ellyn, IL
National Provider Identifier
1912969122
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
21 W 466 Buckingham Rd
Glen Ellyn, IL 60137-6425
Phone
(630) 469-6089
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X IL Primary

Addresses

Primary practice location

21 W 466 Buckingham Rd
Glen Ellyn, IL 60137-6425

Mailing address

21 W 466 Buckingham Rd
Glen Ellyn, IL 60137-6425
Phone (630) 469-6089

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
096000199ILMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912969122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W 466 BUCKINGHAM RD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376425",
            "telephone_number": "630-469-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W 466 BUCKINGHAM RD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376425",
            "telephone_number": "630-469-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBLE",
        "first_name": "CAROL",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MS ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.