Active NPI
Kyle Butzine
- Neurology Physical Therapist
- Melrose Park, IL
National Provider Identifier
1396166047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- License
- 070.020217
- Practice address
- 1225 W Lake St
Melrose Park, IL 60160-4039 - Phone
- (708) 681-3000
- NPI assigned
- Dec 26, 2013
- Last updated
- Dec 26, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | 070.020217 | IL | Primary |
Addresses
Primary practice location
1225 W Lake St
Melrose Park, IL 60160-4039
Mailing address
730 Topeka Dr
Lake Mills, WI 53551-1724
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070.020217 | IL | MD | Neurology Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388016000000",
"number": "1396166047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 TOPEKA DR",
"city": "LAKE MILLS",
"state": "WI",
"postal_code": "535511724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 W LAKE ST",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601604039",
"telephone_number": "708-681-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTZINE",
"first_name": "KYLE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-26",
"last_updated": "2013-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "IL",
"license": "070.020217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.