Active NPI
Raymond Vincent Pineda
- Physical Therapist
- Bensenville, IL
National Provider Identifier
1396211561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070023801
- Practice address
- 111 E Washington St
Bensenville, IL 60106-2674 - Phone
- (630) 766-5800
- NPI assigned
- Oct 15, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070023801 | IL | Primary |
Addresses
Primary practice location
111 E Washington St
Bensenville, IL 60106-2674
Mailing address
111 E Washington St
Bensenville, IL 60106-2674
Other practice location 1
2536 Linda Ct
Glenview, IL 60025-4724
Phone (224) 522-7109
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 |
|---|---|---|---|
| 070023801 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539561600000",
"number": "1396211561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E WASHINGTON ST",
"city": "BENSENVILLE",
"state": "IL",
"postal_code": "601062674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E WASHINGTON ST",
"city": "BENSENVILLE",
"state": "IL",
"postal_code": "601062674",
"telephone_number": "630-766-5800"
}
],
"practiceLocations": [
{
"address_1": "2536 Linda Ct",
"address_purpose": "LOCATION",
"city": "Glenview",
"state": "IL",
"postal_code": "600254724",
"country_code": "US",
"telephone_number": "224-522-7109",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PINEDA",
"first_name": "RAYMOND",
"middle_name": "VINCENT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-15",
"last_updated": "2018-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070023801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bensenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.