MR. JASON SCOTT PEQUETTE (NPI# 1629046826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629046826 |
| Entity Type | Individual |
| Full Name | MR. JASON SCOTT PEQUETTE |
| Credential | MS,ATC,CSCS |
| Practice Address |
790 Remington Blvd Bolingbrook IL 60440-4909 |
| Practice Telephone | 6302692222 |
| Mailing Telephone | 6302962222 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2015-01-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096-001043 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
790 REMINGTON BLVD |
| City | BOLINGBROOK |
| State | IL |
| Zip Code | 60440-4909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073163218 | Lindsay Elizabeth Thueson | Physical Therapist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2019-09-19 |
| 1104311802 | Brittny E Silke | Physical Therapist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2018-06-25 |
| 1477047140 | Logan Gudde | Physical Therapist | 790 Remington Blvd, Bolingbrook, IL 60440 | 2018-06-18 |
| 1598281164 | Erin Renner | Specialist/Technologist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2017-08-16 |
| 1356878870 | Autum Korosic | Specialist/Technologist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2017-05-15 |
| 1003351008 | Patricia Richardson | Specialist/Technologist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2016-12-29 |
| 1568911089 | Ryan Delcambre | Physical Therapist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2016-09-26 |
| 1871048553 | Chadwick Hadley | Physical Therapist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2016-08-23 |
| 1053764407 | Latifah Teyonna Reid | Specialist/Technologist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2016-07-21 |
| 1205289774 | Karyn Smith | Physical Therapy Assistant | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2016-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1851949150 | Rachel Nicole Weis | Student in an Organized Health Care Education/Training Program | 777 Falconridge Way, Bolingbrook, IL 60440 | 2019-08-29 |
| 1578072815 | Onna Ford-kendrick | Nurse Practitioner | 151 E. Briarcliff Rd, -, Bolingbrook, IL 60440 | 2017-09-28 |
| 1891245213 | Megan Lotarski | Specialist/Technologist | 6 Copper Ct, Bolingbrook, IL 60440 | 2016-10-10 |
| 1144775800 | Mitchell Quill | Chiropractor | 550 E Boughton Rd Ste 150, Bolingbrook, IL 60440 | 2016-08-23 |
| 1477914125 | Alessia L. Elerby | Specialist | 128 S Cass Ave, Westmont, IL 60440 | 2016-03-09 |
| 1982073821 | Melissa Perkins | Counselor | 511 Preston Drive, Bolingbrook, IL 60440 | 2015-09-22 |
| 1821467754 | Advanced Patient Care, LLC. | Pharmacy | 335-337 Remington Blvd., Bolingbrook, IL 60440 | 2015-09-22 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| 1467864512 | Alice II Salons | Specialist | 311 Quadr,., Bolingbrook, IL 60440 | 2014-05-23 |
| Find all providers in zip 60440 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417599879 | Concepcion Perez | Specialist/Technologist | 273 Seneca Way, Bolingbrook, IL 60440-1738 | 2019-10-17 |
| 1922563279 | Danielle M Osterman | Specialist/Technologist | 532 N Ashbury Ave, Bolingbrook, IL 60440-1202 | 2019-01-31 |
| 1508371964 | Caitlin Yone | Specialist/Technologist | 284 Picardy Ln, Bolingbrook, IL 60440-4529 | 2017-12-07 |
| 1891245213 | Megan Lotarski | Specialist/Technologist | 6 Copper Ct, Bolingbrook, IL 60440 | 2016-10-10 |
| 1720472459 | Zach Kuchta | Specialist/Technologist | 779 Brompton Ln, Bolingbrook, IL 60440-6115 | 2015-03-19 |
| 1720471865 | Nathaniel Paul Zarembski | Specialist/Technologist | 646 N Ashbury Ave, Bolingbrook, IL 60440-1164 | 2015-03-13 |
| 1568710465 | Anthony M Buonamici | Specialist/Technologist | 313 North Weber Road, Bolingbrook, IL 60490 | 2012-08-27 |
| 1851357552 | Richard Thomas Wright | Specialist/Technologist | 218 N Bolingbrook Dr, Bolingbrook, IL 60440-2386 | 2006-04-22 |
| 1457329278 | Gina Younce | Specialist/Technologist | 365 Raider Way, Bolingbrook, IL 60440-4893 | 2006-03-08 |
| 1598281164 | Erin Renner | Specialist/Technologist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2017-08-16 |
| Find all providers in BOLINGBROOK | ||||
| City | BOLINGBROOK |
| Zip Code | 60440 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.