Individual provider Active NPI

Jerod Gard, P.T.

  • Physical Therapist
  • West Chicago, IL
National Provider Identifier
1992099592
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.017443 Issued in IL
Practice address
440 E Roosevelt Rd Ste 104
West Chicago, IL 60185-3909
Phone
(630) 876-9186
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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 070.017443 IL Primary

Addresses

Primary practice location

440 E Roosevelt Rd Ste 104
West Chicago, IL 60185-3909

Mailing address

440 E Roosevelt Rd Ste 104
West Chicago, IL 60185-3909
Phone (630) 876-9186

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40067CAMDGeneral Practice Dentistry
070.017443ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1992099592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E ROOSEVELT RD STE 104",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601853909",
            "telephone_number": "630-876-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E ROOSEVELT RD STE 104",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601853909",
            "telephone_number": "630-876-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARD",
        "first_name": "JEROD",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.017443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.