Marinel Maravilla, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070007274 Issued in IL

Practice address

1122 Main St
Antioch, IL 60002-1808

Phone

(847) 395-0321

Fax

(847) 395-0298

NPI assigned

Sep 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marinel Caballo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1366961963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 MAIN ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021808",
            "telephone_number": "847-395-0321",
            "fax_number": "847-395-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAVILLA",
        "first_name": "MARINEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070007274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINEL",
            "last_name": "CABALLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terry Loe, LMT, CMT
• Sheila Marie Loos, LMT
• Nikole Losch, DPT
• Sharon Lynn Luhn, LCSW
• Kathrin Lukowicz
• Cynthia Maria Marzette, LCSW
• Jeannine M Mattson, PT
• Rise Michele McElhenney, MA CCCSLP
• Jennifer McKinney
• Terese Mae McMahon, OTR/L

• Physical Therapist in Antioch, IL
• Providers in Antioch, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.

Verify at the official NPI Registry.