Mickow Ce Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MICKOW CE PHYSICAL THERAPY, LLC

Practice address

1200 Old Skokie Valley Rd
Highland Park, IL 60035-3036

Phone

(847) 748-8804

Fax

(847) 810-0046

NPI assigned

Jan 15, 2019

Organization subpart

No

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

Authorized official

Name

Chelsea Ellis, PT

Title

President

Phone

(847) 748-8804

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1235603945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 GLENDALE ST",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600902933",
            "telephone_number": "847-748-8804",
            "fax_number": "847-810-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD SKOKIE VALLEY RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353036",
            "telephone_number": "847-748-8804",
            "fax_number": "847-810-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICKOW CE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-748-8804",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Meza, LMT
• Xingjian Miao, RN
• Michael P. Bert, O.D. P.C.
• Michael R Binder
• Michelle a Field MD SC
• Andrzej J. Miga, M.D.
• Mary O'Halloran Miller
• Deborah S. Milling, M.A.
• Mindfully Well PLLC
• Minx Wellness, PC

• Physical Therapist in Highland Park, IL
• Providers in Highland 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 Feb 12, 2019; 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.