Individual provider Active NPI

Mathew Thengil, MA, OTR/L

  • Occupational Therapist
  • Niles, IL
National Provider Identifier
1124468368
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.006600 Issued in IL
Practice address
6840 W Touhy Ave
Niles, IL 60714-4520
Phone
(847) 647-6400
NPI assigned
Jul 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.006600 IL Primary

Addresses

Primary practice location

6840 W Touhy Ave
Niles, IL 60714-4520

Mailing address

1687 Whitehall CT
Wheeling, IL 60090-6905
Phone (847) 647-6400

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 Arts

State licenses

LicenseStateTypeSpecialty
056.006600ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1124468368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 WHITEHALL CT",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600906905",
            "telephone_number": "847-647-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 W TOUHY AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144520",
            "telephone_number": "847-647-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THENGIL",
        "first_name": "MATHEW",
        "credential": "MA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.006600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.