John Malacad Abantao Jr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.024114 Issued in IL

Practice address

1001 E Pells St
Paxton, IL 60957-1300

Phone

(217) 379-4361

NPI assigned

May 23, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Empowerme Rehabilitation Illinois, LLC

  • Occupational Therapist
  • Edwardsville, IL
  • NPI 1679098263

  Physical Therapist

  NPD
• Empowerme Rehabilitation Illinois, LLC

  • Rehabilitation Clinic/Center
  • Mount Carmel, IL
  • NPI 1962073734

  Physical Therapist

  NPD
• Empowerme Wellness Kansas City, LLC

  • Multi-Specialty Clinic/Center
  • Belleville, IL
  • NPI 1174118103

  Physical Therapist

  NPD
• Empowerme Wellness Kansas City, LLC

  • Rehabilitation Clinic/Center
  • Liberty, MO
  • NPI 1174299044
  NPD
• Empowerme Rehabilitation Illinois, LLC

  • Rehabilitation Clinic/Center
  • Sparta, IL
  • NPI 1720659584

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1003554759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E 13TH ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361104",
            "telephone_number": "929-213-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E PELLS ST",
            "city": "PAXTON",
            "state": "IL",
            "postal_code": "609571300",
            "telephone_number": "217-379-4361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E Fulton St",
            "address_purpose": "LOCATION",
            "city": "Paxton",
            "state": "IL",
            "postal_code": "609571716",
            "country_code": "US",
            "telephone_number": "217-379-2116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABANTAO",
        "first_name": "JOHN",
        "middle_name": "MALACAD",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040925-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.024114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Accolade Healthcare of Paxton LLC
• Accolade Healthcare of Paxton Senior Living LLC
• Accolade Healthcare of Paxton Senior Living LLC
• Accolade Healthcare of the Heartland LLC
• Accolade Healthcare of the Heartland LLC

• All providers in Paxton, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.