Taylor Kistulinec, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070028122 Issued in IL

Practice address

8755 S Harlem Ave
Bridgeview, IL 60455-1905

Phone

(708) 430-2295

NPI assigned

Mar 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Reinvent Health Inc

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1215763206

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1063272888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3038 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8755 S HARLEM AVE",
            "city": "BRIDGEVIEW",
            "state": "IL",
            "postal_code": "604551905",
            "telephone_number": "708-430-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTULINEC",
        "first_name": "TAYLOR",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hassen Kasem
• Mohammad Khader
• Lisa Kherwish
• Rhonda Ibrahim Khouri, DDS
• Joseph Kim, DPT
• Natali Koeva
• Gregory Kruk, PHARMD.
• Aisha Lane
• Hussein Latif, D.M.D.
• Lean Thyme Nutrition Co

• Physical Therapist in Bridgeview, IL
• Providers in Bridgeview, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.