Michael Thomas Shoemake

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MICHAEL THOMAS SHOEMAKE

Practice address

1017 W Park Ave
Suite B
Libertyville, IL 60048-2502

Phone

(847) 997-0650

Fax

(815) 385-5753

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Thomas Shoemake, PT

Title

President

Phone

(847) 996-0650

Specialties & licenses 1

Addresses

Other names 1

• Momentum Physical Therapy Doing business as

Locations

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1154484368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W PARK AVE",
            "address_2": "SUITE B",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482502",
            "telephone_number": "847-996-0650",
            "fax_number": "815-385-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W PARK AVE",
            "address_2": "SUITE B",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482502",
            "telephone_number": "847-997-0650",
            "fax_number": "815-385-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL THOMAS SHOEMAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-996-0650",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Momentum Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Meyer, ATC
• Tiffany Micek, LCSW
• Michael L Klestinki Acsw & Associates P.C.
• Michael L Klestinski & Associates, P.C.
• Michael S Greenbaum MD S C
• Benjamin Michaels, PSYD
• Kathy Michalak, CCC-SLP
• Emily Lauren Michel, MS, MA
• Rannveig Middleton, M.D.
• John Anthony Mihelich, HIS

• Physical Therapy Clinic/Center in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.