Active NPI
Stephanie Lynn Booton, ATC/L
- Athletic Trainer
- Glen Ellyn, IL
National Provider Identifier
1942269337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 670 Crescent Blvd
Glen Ellyn, IL 60137-4286 - Phone
- (630) 942-7570
- Fax
- (630) 469-8608
- NPI assigned
- Mar 22, 2006
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | IL | Primary |
Addresses
Primary practice location
670 Crescent Blvd
Glen Ellyn, IL 60137-4286
Mailing address
1592 Timber TRL
Wheaton, IL 60187-6143
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 |
|---|---|---|---|
| 096.002203 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185753600000",
"number": "1942269337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1592 TIMBER TRL",
"city": "WHEATON",
"state": "IL",
"postal_code": "601876143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 CRESCENT BLVD",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601374286",
"telephone_number": "630-942-7570",
"fax_number": "630-469-8608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTON",
"first_name": "STEPHANIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "ATC/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-22",
"last_updated": "2007-07-30",
"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 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.