Active NPI
Lori Connell
- Athletic Trainer
- Carol Stream, IL
National Provider Identifier
1992870257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 547 S Schmale Rd
Carol Stream, IL 60188-2451 - Phone
- (630) 462-7020
- NPI assigned
- Nov 22, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
547 S Schmale Rd
Carol Stream, IL 60188-2451
Mailing address
317 Malibu Dr
Bolingbrook, IL 60440-2042
Phone (630) 677-7399
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 096001583 | Other | IL | LICENSE# |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992870257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 MALIBU DR",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604402042",
"telephone_number": "630-677-7399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "547 S SCHMALE RD",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601882451",
"telephone_number": "630-462-7020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELL",
"first_name": "LORI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "096001583",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carol Stream, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.