Individual provider Active NPI

Christian Vega, PTA

  • Physical Therapy Assistant
  • Lemont, IL
National Provider Identifier
1457954356
Registry record updated Nov 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.009146 Issued in IL
Practice address
12450 Walker Rd
Lemont, IL 60439-9301
Phone
(630) 243-0400
NPI assigned
Nov 21, 2020
Last updated
Nov 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.009146 IL Primary

Addresses

Primary practice location

12450 Walker Rd
Lemont, IL 60439-9301

Mailing address

12450 Walker Rd
Lemont, IL 60439-9301

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

LicenseStateTypeSpecialty
160.009146ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1457954356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 WALKER RD",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604399301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 WALKER RD",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604399301",
            "telephone_number": "630-243-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "CHRISTIAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-21",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.009146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; 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.