Organization Active NPI

Thomas G. Mulvey , M.S., P.T., M.B.a., P.C.

  • Physical Therapy Clinic/Center
  • Oak Lawn, IL
National Provider Identifier
1043384761
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
THOMAS G. MULVEY , M.S., P.T., M.B.A., P.C.
Practice address
4004 W 111TH St
Oak Lawn, IL 60453-5703
Phone
(708) 424-4025
Fax
(708) 424-4591
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Mr. Thomas Gerard Mulvey, MS PT MBANPI 1528285681
Title
Owner
Phone
(708) 424-4025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X IL
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4004 W 111TH St
Oak Lawn, IL 60453-5703

Mailing address

4004 W 111TH St
Oak Lawn, IL 60453-5703
Phone (708) 424-4025

Other names 1

  • Athletex Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000721 IL Part B Supplier - Clinic/Group Practice 4880856517 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Oak Lawn, IL; Orland Park, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Athletex Physical Thera2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1043384761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 W 111TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535703",
            "telephone_number": "708-424-4025",
            "fax_number": "708-424-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 W 111TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535703",
            "telephone_number": "708-424-4025",
            "fax_number": "708-424-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G. MULVEY , M.S., P.T., M.B.A., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "MULVEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-424-4025",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS PT MBA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athletex Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Athletex Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.