Individual provider Active NPI

Ma. Lourdes L Ipapo, PT

  • Physical Therapy Clinic/Center
  • Chicago, IL
National Provider Identifier
1255689220
Registry record updated Aug 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
070015513 Issued in IL
Practice address
5421 N East River Rd
Apt 404
Chicago, IL 60656-1129
Phone
(773) 895-7599
NPI assigned
Aug 24, 2012
Last updated
Aug 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 070015513 IL Primary

Addresses

Primary practice location

5421 N East River Rd
Apt 404
Chicago, IL 60656-1129

Mailing address

5461 N East River Rd
Apt 900
Chicago, IL 60656-1128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121128000751 IL Practitioner - Physical Therapist in Private Practice 4789836628 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Maxx LLC Physical Therapy CurrentSince May 21, 2024 Accepting new patients

Locations

415 W Golf Rd
Ste 52
Arlington Hts, IL 60005
Phone (847) 258-5420

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1345766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376179200000",
    "number": "1255689220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 N EAST RIVER RD",
            "address_2": "APT 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 N EAST RIVER RD",
            "address_2": "APT 404",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561129",
            "telephone_number": "773-895-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPAPO",
        "first_name": "MA. LOURDES",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-24",
        "last_updated": "2013-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070015513",
            "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 Aug 11, 2013; 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.