Nicole M Barak, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.009245 Issued in IL

Practice address

545 Belmont LN
Carol Stream, IL 60188-2467

Phone

(630) 523-8972

NPI assigned

Jul 6, 2021

Last updated

Jul 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1073184545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7547 BRISTOL LN UNIT 3",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601337231",
            "telephone_number": "847-271-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BELMONT LN",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882467",
            "telephone_number": "630-523-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAK",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.009245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• William Bayer, MD
• BDD of Illinois P.C. (Carol Stream Dental Associates)
• Patrick F Bednar, MD

• Physical Therapy Assistant in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.