Active NPI
Ryan Mettler, DPT
- Physical Therapist
- Bolingbrook, IL
National Provider Identifier
1366822934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3460
- Practice address
- 790 Remington Blvd
Bolingbrook, IL 60440-4909 - Phone
- (630) 296-2223
- Fax
- (630) 759-9510
- NPI assigned
- Jun 9, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3460 | NE | Primary |
Addresses
Primary practice location
790 Remington Blvd
Bolingbrook, IL 60440-4909
Mailing address
410 E 22ND St
Fremont, NE 68025-2609
Phone (402) 721-3908
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3460 | NE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1366822934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 E 22ND ST",
"city": "FREMONT",
"state": "NE",
"postal_code": "680252609",
"telephone_number": "402-721-3908",
"fax_number": "402-721-4047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METTLER",
"first_name": "RYAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-09",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
- Meijer Great Lakes Limited Partnership
- Meijer Great Lakes Limited Partnership
- Jessica Melendez, MS, LAT, ATC
- Meli Development Center
- Christina Tingson Mercado
- Mga Home Health Care, Inc.
- Judith Micek, MOT/L,CHT
- Midwest Express Care 2, Inc
- Midwest Functional Psychiatry
- Midwest Hyperbaric Institute, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.