Active NPI
Leslie Buckner, PT
- Physical Therapist
- Oak Lawn, IL
National Provider Identifier
1992049977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-013137
- Practice address
- 4440 W 95TH St
Oak Lawn, IL 60453-2600 - Phone
- (708) 684-5369
- NPI assigned
- Nov 15, 2012
- 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 | 070-013137 | IL | Primary |
Addresses
Primary practice location
4440 W 95TH St
Oak Lawn, IL 60453-2600
Mailing address
12533 S Central Park Ave
Alsip, IL 60803-1086
Phone (708) 250-1654
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 |
|---|---|---|---|
| 070-013137 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1992049977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12533 S CENTRAL PARK AVE",
"city": "ALSIP",
"state": "IL",
"postal_code": "608031086",
"telephone_number": "708-250-1654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532600",
"telephone_number": "708-684-5369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNER",
"first_name": "LESLIE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-013137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.