Kimberly Weber, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070009838 Issued in IL

Practice address

400 Trotter Dr
Heyworth, IL 61745-9212

Phone

(309) 310-5310

NPI assigned

Aug 4, 2014

Last updated

Apr 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Dujakovich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1982013090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TROTTER DR",
            "city": "HEYWORTH",
            "state": "IL",
            "postal_code": "617459212",
            "telephone_number": "309-310-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TROTTER DR",
            "city": "HEYWORTH",
            "state": "IL",
            "postal_code": "617459212",
            "telephone_number": "309-310-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070009838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DUJAKOVICH",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Heyworth, IL
• Providers in Heyworth, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.

Verify at the official NPI Registry.