Myrell Mae Requilme, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018389 Issued in IL

Practice address

16170 Kingsport Rd
Orland Park, IL 60467-5602

Phone

(773) 580-2699

NPI assigned

Apr 23, 2015

Last updated

Apr 23, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Rex Therapeutics, LLC

  • Physical Therapist
  • Skokie, IL
  • NPI 1740838226
  Medicare reassignment

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1255728523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16170 KINGSPORT RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16170 KINGSPORT RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675602",
            "telephone_number": "773-580-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REQUILME",
        "first_name": "MYRELL MAE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Reid, PHD
• Diane Reilly, RD
• Kathleen Reilly, LPC
• Relief Urgent Care LLC
• Victoria Marie Rendulic, APRN, FNP-C
• Alan H. Resnick, M.D.
• Restorative Assurance
• Revello Chiropractic DC SC (Body Bliss Wellness Center)
• John W. Revello, D.C.
• Joshua Michael Reyes, CCC-SLP

• Physical Therapist in Orland Park, IL
• Providers in Orland 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 Apr 23, 2015; 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.