Active NPI
Carlos Pecciotto Jr.
- Massage Therapist
- Chicago, IL
National Provider Identifier
1194317735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227-002147
- Practice address
- 5940 N Sheridan Rd
Chicago, IL 60660-3644 - Phone
- (773) 332-0139
- NPI assigned
- Feb 4, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227-002147 | IL | Primary |
Addresses
Primary practice location
5940 N Sheridan Rd
Chicago, IL 60660-3644
Mailing address
2142 W Superior St FL 1
Chicago, IL 60612-1316
Phone (773) 332-0139
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 |
|---|---|---|---|
| 227-002147 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612396800000",
"number": "1194317735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2142 W SUPERIOR ST FL 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606121316",
"telephone_number": "773-332-0139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5940 N SHERIDAN RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606603644",
"telephone_number": "773-332-0139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECCIOTTO",
"first_name": "CARLOS",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-04",
"last_updated": "2021-02-04",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "IL",
"license": "227-002147",
"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 Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.