Active NPI
John Martin Sandstrom
- Physical Therapist
- Elmhurst, IL
National Provider Identifier
1154854859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070009936
- Practice address
- 615 N Emroy Ave
Elmhurst, IL 60126-1940 - Phone
- (630) 806-1518
- NPI assigned
- Apr 10, 2017
- Sex
- Male
- 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 | 070009936 | IL | Primary |
Addresses
Primary practice location
615 N Emroy Ave
Elmhurst, IL 60126-1940
Mailing address
615 N Emroy Ave
Elmhurst, IL 60126
Phone (630) 806-1518
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070009936 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516320000000",
"number": "1154854859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 N EMROY AVE",
"city": "ELMHURST",
"state": "IL",
"postal_code": "60126",
"telephone_number": "630-806-1518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 N EMROY AVE",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601261940",
"telephone_number": "630-806-1518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDSTROM",
"first_name": "JOHN",
"middle_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-10",
"last_updated": "2018-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070009936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.