Ronald Paetsch I, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.005646 Issued in IL

Practice address

14500 S Manistee Ave.
Burnham, IL 60633

Phone

(708) 862-1260

NPI assigned

Apr 2, 2014

Sex

Male

Sole proprietor

Yes

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1154749513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14500 S MANISTEE AVE",
            "city": "BURNHAM",
            "state": "IL",
            "postal_code": "606332004",
            "telephone_number": "708-862-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 S MANISTEE AVE.",
            "city": "BURNHAM",
            "state": "IL",
            "postal_code": "60633",
            "telephone_number": "708-862-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAETSCH",
        "first_name": "RONALD",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.005646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Antoinette Smith, LPN
• Regina Smith

• Physical Therapy Assistant in Burnham, IL
• Providers in Burnham, 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 Aug 12, 2015; 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.