Individual provider Active NPI

Mohamed Aly El-Meghallawy, PT

  • Physical Therapist
  • Oak Lawn, IL
National Provider Identifier
1366004699
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070024157 Issued in IL
Practice address
6060 W 95TH St
Oak Lawn, IL 60453-2778
Phone
(708) 952-1052
Fax
(708) 952-1053
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070024157 IL Primary

Addresses

Primary practice location

6060 W 95TH St
Oak Lawn, IL 60453-2778

Mailing address

7120 W 108TH St Unit 1B
Worth, IL 60482-1666
Phone (708) 369-7956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601001522 NY Practitioner - Physical Therapist in Private Practice 0648507277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070024157ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Moves Physical Therapy PC Physical Therapist Current Accepting new patients
Aa to Z Physical Therapy & Rehab Inc CurrentSince Jan 26, 2022 Accepting new patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Feb 26, 2021 Accepting new patients
Dynamic Moves Physical Therapy, P.C. Physical Therapist Current Accepting new patients

Locations

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1366004699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 W 108TH ST UNIT 1B",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604821666",
            "telephone_number": "708-369-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532778",
            "telephone_number": "708-952-1052",
            "fax_number": "708-952-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-MEGHALLAWY",
        "first_name": "MOHAMED",
        "middle_name": "ALY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.