Active NPI
Amanda Jean Gaikwad, PT
- Physical Therapist
- Kankakee, IL
National Provider Identifier
1932689320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.011686
- Practice address
- 1601 Butterfield TRL
Kankakee, IL 60901-2959 - Phone
- (815) 936-6500
- NPI assigned
- Aug 15, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.011686 | IL | Primary |
Addresses
Primary practice location
1601 Butterfield TRL
Kankakee, IL 60901-2959
Mailing address
2233 Spruce Rd
Homewood, IL 60430-1047
Phone (708) 829-0491
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 |
|---|---|---|---|
| 070.011686 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1932689320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2233 SPRUCE RD",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604301047",
"telephone_number": "708-829-0491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 BUTTERFIELD TRL",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012959",
"telephone_number": "815-936-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAIKWAD",
"first_name": "AMANDA",
"middle_name": "JEAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.011686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.