Active NPI
Lorenzo Antonio Cortez Velazco, ATC
- Athletic Trainer
- Oak Brook, IL
National Provider Identifier
1992272801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096004610
- Practice address
- 625 Enterprise Dr
Oak Brook, IL 60523-8813 - Phone
- (224) 814-9456
- NPI assigned
- Oct 29, 2018
- Sex
- Male
- 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 | 096004610 | IL | Primary |
Addresses
Primary practice location
625 Enterprise Dr
Oak Brook, IL 60523-8813
Mailing address
1416 Beverly Dr
Round Lake Beach, IL 60073-1509
Phone (224) 814-9456
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 |
|---|---|---|---|
| 096004610 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540771200000",
"number": "1992272801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1416 BEVERLY DR",
"city": "ROUND LAKE BEACH",
"state": "IL",
"postal_code": "600731509",
"telephone_number": "224-814-9456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 ENTERPRISE DR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605238813",
"telephone_number": "224-814-9456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORTEZ VELAZCO",
"first_name": "LORENZO",
"middle_name": "ANTONIO",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-29",
"last_updated": "2018-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096004610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Oct 29, 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.