Individual provider Active NPI

Chona G Manabat, P.T.

  • Physical Therapist
  • Plainfield, IL
National Provider Identifier
1407865777
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
70011748 Issued in IL
Practice address
24922 Emerald Ave
Plainfield, IL 60585-2968
Phone
(815) 272-4563
Fax
(815) 436-3848
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 70011748 IL Primary

Addresses

Primary practice location

24922 Emerald Ave
Plainfield, IL 60585-2968

Mailing address

24922 Emerald Ave
Plainfield, IL 60585-2968
Phone (815) 272-4563

Other identifiers 1

IdentifierTypeStateIssuer
0039941191OtherILBCBS PROVIDER #

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

LicenseStateTypeSpecialty
70011748ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407865777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24922 EMERALD AVE",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605852968",
            "telephone_number": "815-272-4563",
            "fax_number": "815-436-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24922 EMERALD AVE",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605852968",
            "telephone_number": "815-272-4563",
            "fax_number": "815-436-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANABAT",
        "first_name": "CHONA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70011748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "0039941191",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.