Individual provider Active NPI

Mary R Block, M.S., O.T.R.

  • Mechanotherapist
  • Lake Zurich, IL
National Provider Identifier
1093919441
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
056005720 Issued in IL
Practice address
23527 N East Rd
Lake Zurich, IL 60047-8816
Phone
(847) 438-0993
Fax
(847) 438-1234
NPI assigned
Jun 11, 2007
Last updated
Jun 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 056005720 IL Primary

Addresses

Primary practice location

23527 N East Rd
Lake Zurich, IL 60047-8816

Mailing address

23527 N East Rd
Lake Zurich, IL 60047-8816
Phone (847) 438-0993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
056005720ILMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1093919441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23527 N EAST RD",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600478816",
            "telephone_number": "847-438-0993",
            "fax_number": "847-438-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23527 N EAST RD",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600478816",
            "telephone_number": "847-438-0993",
            "fax_number": "847-438-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "MARY",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "M.S., O.T.R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "IL",
            "license": "056005720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Zurich, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.