Individual provider Active NPI

Aime Maranan

  • Physical Therapist
  • Evanston, IL
National Provider Identifier
1073066122
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.021372 Issued in IL
Practice address
839 Dodge Ave
Evanston, IL 60202-1552
Phone
(847) 859-6384
NPI assigned
Jul 25, 2016
Last updated
Jun 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.021372 IL Primary

Addresses

Primary practice location

839 Dodge Ave
Evanston, IL 60202-1552

Mailing address

1309 Oak Ave Apt 1S
Evanston, IL 60201-4246
Phone (407) 257-2572

Other practice location 1

3452 Lake Lynda Dr Ste 200
Orlando, FL 32817-1481
Phone (407) 257-2572

Other practice location 2

63 Fountainhead Dr
Westmont, IL 60559-2461
Phone (407) 257-2572

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170524002834 IL Practitioner - Physical Therapist in Private Practice 5193092096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skillz Physical Therapy LLCGroup PAC ID 7113349390, 2 clinicians

Practice addresses (Care Compare)

839 Dodge Ave
Evanston, IL 60202-1552
Phone (847) 859-6240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.021372ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Skillz Physical Therapy LLC Physical Therapist CurrentSince Jun 8, 2020 Accepting new patients

Locations

839 Dodge Ave
Evanston, IL 60202
Phone (847) 859-6240

2909 MacArthur Blvd
Northbrook, IL 60062
Phone (224) 300-6158

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1073066122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 OAK AVE APT 1S",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014246",
            "telephone_number": "407-257-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 DODGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021552",
            "telephone_number": "847-859-6384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3452 Lake Lynda Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328171481",
            "country_code": "US",
            "telephone_number": "407-257-2572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "63 Fountainhead Dr",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605592461",
            "country_code": "US",
            "telephone_number": "407-257-2572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARANAN",
        "first_name": "AIME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.021372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.