Mina Milad Antonuos

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160008510 Issued in IL

Practice address

6623 Oak Forest Ave Apt 12
Tinley Park, IL 60477-3569

Phone

(708) 518-5440

NPI assigned

Jan 28, 2022

Sex

Male

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": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1124771241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6623 OAK FOREST AVE APT 12",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773569",
            "telephone_number": "708-518-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6623 OAK FOREST AVE APT 12",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773569",
            "telephone_number": "708-518-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONUOS",
        "first_name": "MINA",
        "middle_name": "MILAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160008510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Michelle Ang
• Nicholas A Angelopoulos, DO
• Anthony L Buckles MD
• Ashley Dajay Anthony
• Kersey H Antia, PHD
• Lori Arambula, BCBA
• Michelle R Archibald, PT, DPT
• Dy'Jhanik Armfield
• Aretha Armstrong, LPC
• Kandace L Arnold

• Physical Therapy Assistant in Tinley Park, IL
• Providers in Tinley Park, 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 Jan 28, 2022; 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.