Active NPI
Gemma Mata
- Physical Therapist
- Chicago, IL
National Provider Identifier
1144647405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.017756
- Practice address
- 6833 N Kedzie Ave
Apt 810
Chicago, IL 60645-2897 - Phone
- (773) 645-5167
- NPI assigned
- Mar 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.017756 | IL | Primary |
Addresses
Primary practice location
6833 N Kedzie Ave
Apt 810
Chicago, IL 60645-2897
Mailing address
6833 N Kedzie Ave
Apt 810
Chicago, IL 60645-2897
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.017756 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395705600000",
"number": "1144647405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6833 N KEDZIE AVE",
"address_2": "APT 810",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606452897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6833 N KEDZIE AVE",
"address_2": "APT 810",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606452897",
"telephone_number": "773-645-5167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "GEMMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-25",
"last_updated": "2014-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.017756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.