Individual provider Active NPI

Michelle Ann Bobek, L/PTA

  • Physical Therapy Assistant
  • Chicago, IL
National Provider Identifier
1336328889
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808
Phone
(186) 638-6077
NPI assigned
Nov 1, 2007
Last updated
Nov 1, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X IL Primary

Addresses

Primary practice location

222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808

Mailing address

1052 Grandview Ave
Lockport, IL 60441-3647
Phone (815) 603-4556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160003691ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1336328889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1052 GRANDVIEW AVE",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604413647",
            "telephone_number": "815-603-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RIVERSIDE PLZ",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065808",
            "telephone_number": "186-638-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBEK",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "L/PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": null,
            "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 Nov 1, 2007; 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.