Industrial Physical Therapy, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

INDUSTRIAL PHYSICAL THERAPY, INC

Practice address

11600 S Kedzie Ave
Merrionette Park, IL 60803-6307

Phone

(708) 371-6441

NPI assigned

Jun 5, 2012

Organization subpart

No

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

Authorized official

Name

Witold Mierzwa

Title

President

Phone

(708) 371-6441

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1194086280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036307",
            "telephone_number": "708-371-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRIAL PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "MIERZWA",
        "authorized_official_first_name": "WITOLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-371-6441"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Kathleen Hayes, MSN, APRN, FNP-C
• Ky'Anna Haywood
• Daniel R Hennigan
• Melina Hernandez, MSW
• Micaela Humenik, MSW
• Neha Iyengar, MD
• Maha Jabbar, OD
• Tatyana Jackson
• Smriti Jain, OD
• James & Huddleston Center for Pain, S.C.

• Physical Therapy Clinic/Center in Merrionette Park, IL
• Providers in Merrionette Park, 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 Jun 5, 2012; 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.