Active NPI
Mia Angelina Martinez
- Recreation Therapist
- Vernon Hills, IL
National Provider Identifier
1194541003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- Practice address
- 565 Lakeview Pkwy
Vernon Hills, IL 60061-1857 - Phone
- (877) 486-4140
- NPI assigned
- Nov 25, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | Primary |
Addresses
Primary practice location
565 Lakeview Pkwy
Vernon Hills, IL 60061-1857
Mailing address
37249 N Grandwood Dr
Gurnee, IL 60031-1352
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1194541003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37249 N GRANDWOOD DR",
"city": "GURNEE",
"state": "IL",
"postal_code": "600311352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 LAKEVIEW PKWY",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611857",
"telephone_number": "877-486-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "MIA",
"middle_name": "ANGELINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-25",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.