Active NPI
Pawel Tomasz Trybula, PTA
- Physical Therapy Assistant
- Glen Ellyn, IL
National Provider Identifier
1467292565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160.009942
- Practice address
- 95 Carleton Ave
Glen Ellyn, IL 60137-5500 - Phone
- (630) 469-5555
- NPI assigned
- May 28, 2024
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 160.009942 | IL | Primary |
Addresses
Primary practice location
95 Carleton Ave
Glen Ellyn, IL 60137-5500
Mailing address
502 W Huntington Commons Rd Apt 144
Mt Prospect, IL 60056-5255
Phone (708) 323-7752
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 |
|---|---|---|---|
| 160.009942 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1467292565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 W HUNTINGTON COMMONS RD APT 144",
"city": "MT PROSPECT",
"state": "IL",
"postal_code": "600565255",
"telephone_number": "708-323-7752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 CARLETON AVE",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601375500",
"telephone_number": "630-469-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRYBULA",
"first_name": "PAWEL",
"middle_name": "TOMASZ",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-28",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.009942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Ellyn, IL
- Transtech Communication Inc
- Travel Health Partners Il PLLC
- Tri-County Counseling Services, P.C.
- Thomas Trousdale, L.C.S.W.
- Trusted Hearts Home Care Services, LLC
- Jean Marie Tschampa Lopotko, PHARM.D, LCPC, CADC
- Elaine M Turner, CSFA
- Urgent Medical Diagnostic, Inc
- Sherri Lynn Klis Urso, MD
- Lauren Vacek, CNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.