Individual provider Active NPI

Kelsey Kunkelmann, DPT

  • Physical Therapist
  • Oak Brook, IL
National Provider Identifier
1962034595
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070024979 Issued in IL
Practice address
2011 York Rd
Oak Brook, IL 60523-1992
Phone
(877) 632-6637
Fax
(708) 409-5179
NPI assigned
Feb 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070024979 IL Primary

Addresses

Primary practice location

2011 York Rd
Oak Brook, IL 60523-1992

Mailing address

2011 York Rd
Oak Brook, IL 60523-1992
Phone (877) 632-6637

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkunkelmann197494@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200313001113 IL Practitioner - Physical Therapist in Private Practice 3870921471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

2011 York Rd
Suite 3000
Oak Brook, IL 60523-2156
Phone (877) 632-6637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopaedics at Rush, LLC CurrentSince Nov 7, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Nov 7, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Nov 7, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Nov 7, 2022 Accepting new patients
Orthomidwest, PLLC Physical Therapist Current Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

2011 York Rd
Oak Brook, IL 60523
Phone (312) 942-6100

2011 York Rd
Ste 1500
Oak Brook, IL 60523
Phone (708) 492-5630

2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • Direct secure messaging: kelsey.kunkelmann.1@12576.direct.athenahealth.com
  • Direct secure messaging: kkunkelmann197494@dulyhealthandcare.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1962034595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 YORK RD",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231992",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 YORK RD",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231992",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKELMANN",
        "first_name": "KELSEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkunkelmann197494@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "854 Roosevelt Rd # E10",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601376057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.