Mary Clark Wyler

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

830 S Addison Ave
Villa Park, IL 60181-2877

Phone

(630) 620-4433

Fax

(630) 620-1148

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Clark Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Easter Seals Dupage and the Fox Valley Region

  • Physical Therapist
  • Villa Park, IL
  • NPI 1568460681
  Medicare reassignment NPD

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194832964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S ADDISON AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812877",
            "telephone_number": "630-620-4433",
            "fax_number": "630-620-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S ADDISON AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812877",
            "telephone_number": "630-620-4433",
            "fax_number": "630-620-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLER",
        "first_name": "MARY",
        "middle_name": "CLARK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Jane Wine, MSW
• Toyia L Winfield
• Suzanne Wolff
• Katherine Renee Woltering, MPT
• Kassidy Worth, MS
• Sandra Jay Zeidler, MSW LCSW

• Physical Therapist in Villa Park, IL
• Providers in Villa Park, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.