Mark Costales, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070017478 Issued in IL

Practice address

1460 Market St
Des Plaines, IL 60016-4643

Phone

(847) 813-0700

NPI assigned

Jun 4, 2016

Last updated

Jun 4, 2016By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

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  NPD (past)
• Morris Mauer MD SC

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  • NPI 1306175005
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• Prime Tech Services Inc

  dba Therapeutic Services of America

  • Home Health Agency
  • Des Plaines, IL
  • NPI 1669843884
  NPD (past)
• Prime Tech Services Inc

  dba Therapeutic Services of America

  • Physical Therapist
  • Des Plaines, IL
  • NPI 1760550362
  NPD (past)

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

{
    "created_epoch": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464998400000",
    "number": "1336598960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "SUITE 300S",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-573-1979",
            "fax_number": "630-573-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MARKET ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164643",
            "telephone_number": "847-813-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTALES",
        "first_name": "MARK",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-04",
        "last_updated": "2016-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Continuing Rehab Services, LLC
• Copious Mind Behavioral Health LLC
• Heather Corbett, M.S., CCC-SLP
• Giselle Yumahira Cordova Yanez
• Corlis Gibson LLC
• Mary Kay Costello
• Costadina Aneziris Costianis
• Linda Russell Courtice, RN
• CPMG Ma, LLC
• Cynthia Craft

• Physical Therapist in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2016; 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.