Chad T Mikesell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12437 Issued in WI

Practice address

3601 30TH Ave
Suite 103
Kenosha, WI 53144-1695

Phone

(262) 657-7071

Fax

(262) 657-0632

NPI assigned

Jul 10, 2013

Last updated

Feb 25, 2019By 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

Other identifiers 1

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": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1396186045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 30TH AVE",
            "address_2": "SUITE 103",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441695",
            "telephone_number": "262-657-7071",
            "fax_number": "262-657-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKESELL",
        "first_name": "CHAD",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-10",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396186045",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Kidney Care, LLC (Midwest Kidney Care-Kenosha Branch)
• Midwest Physicians Anesthesia Service, SC
• Midwest Sports and Interventional Spine SC
• Julie E Miesfeld, PT
• Michael Matthew Mihajlovic, PSYD
• Sandra L Mikolas, APNP
• Lisa Milczarski
• Larissa Milicevic, LPC
• Dawn Miller-Duval, LPC
• Emily Miller, DC

• Physical Therapist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.