Prana Manual Therapy Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRANA MANUAL THERAPY INC.

Practice address

4513 Lincoln Ave Ste 103
Lisle, IL 60532-1291

Phone

(630) 730-5642

NPI assigned

Dec 1, 2021

Organization subpart

No

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

Authorized official

Name

Prutha NanavatiNPI 1912135864

Title

PT

Phone

(630) 730-5642

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prutha S Nanavati

  • Physical Therapist
  • Lisle, IL
  • NPI 1912135864

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1124786652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 LINCOLN AVE STE 103",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321291",
            "telephone_number": "630-730-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 LINCOLN AVE STE 103",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321291",
            "telephone_number": "630-730-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRANA MANUAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "NANAVATI",
        "authorized_official_first_name": "PRUTHA",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "630-730-5642"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Lisle, IL
• Providers in Lisle, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.