My Body Mechanic, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MY BODY MECHANIC, LLC

Practice address

4007 N Kenmore Ave Apt 1
Chicago, IL 60613-2092

Phone

(773) 458-3835

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Corissa J Keefner, PT, DPTNPI 1558300129

Title

Owner, Physical Therapist

Phone

(773) 458-3835

Specialties & licenses 1

Addresses

Other names 1

• Corissa J Keefner Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corissa Jean Keefner, PT, DPT

  • Physical Therapist
  • Chicago, IL
  • NPI 1558300129
  NPD Authorized official

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1295367084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 N KENMORE AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132092",
            "telephone_number": "773-458-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 N KENMORE AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132092",
            "telephone_number": "773-458-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY BODY MECHANIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "KEEFNER",
        "authorized_official_first_name": "CORISSA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "773-458-3835",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corissa J Keefner",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Physical Therapist in Chicago, IL
• Providers in Chicago, 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 10, 2020; 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.