Melissa Fuentes, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

444 N Northwest Hwy Ste 147
Park Ridge, IL 60068-3263

Phone

(847) 707-6744

NPI assigned

Jun 3, 2016

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

• Melissa Horgan Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: mfuentes224330@direct.edward.org

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.

• Fuentes Physical Therapy and Wellness, LLC

  • Physical Therapist
  • Chicago, IL
  • NPI 1578449807
  NPD Authorized official
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1215637699
  NPD (past)

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1215386909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416502",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022417594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N NORTHWEST HWY STE 147",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683263",
            "telephone_number": "847-707-6744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Deerpath",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451952",
            "country_code": "US",
            "telephone_number": "847-482-1433",
            "fax_number": "847-482-1483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 S Clay St",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213257",
            "country_code": "US",
            "telephone_number": "630-967-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "MELISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfuentes224330@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "40 S Clay St",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HORGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deanna M Frazier, FNP-BC
• Serah Amanda Frey, DPT
• Isaac Friedman
• Amanda Friend, M.D.
• Andrei Reynold Froehling, MD
• George J Futris, DDS
• Aurora Alejandra Gabriel
• Andrea Magyar Gadson, MPT
• Robert E Gale, RPH
• Angel G Galvez, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.