Individual provider Active NPI

Alissa J Matzinger, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1417219775
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070019420 Issued in IL
Practice address
150 E Huron St
Suite 1205
Chicago, IL 60611-2999
Phone
(312) 640-1112
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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 070019420 IL Primary

Addresses

Primary practice location

150 E Huron St
Suite 1205
Chicago, IL 60611-2999

Mailing address

205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216
Phone (312) 640-0329

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
070019420ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1417219775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 1205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-640-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZINGER",
        "first_name": "ALISSA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.

Verify at the official NPI Registry.