Daniel Carlos Banuelos

Key facts

NPI

1477020873

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

Practice address

3800 N California Ave
Chicago, IL 60618-3606

Phone

(773) 478-4222

NPI assigned

Oct 24, 2018

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 24, 2018.

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1477020873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 S SHIELDS AVE APT 1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183606",
            "telephone_number": "773-478-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "DANIEL",
        "middle_name": "CARLOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

• Julia Lynn Banta, LCPC
• Rakshanda Banu, MD
• Sirirat R Banuchi, M.D
• Bryan Banuelos Ramirez
• Cesiah Banuelos, LCPC
• Nuvia Banuelos
• Eleanor Resane Banzon, M.D.
• Rhett Enriquez Banzon, PT
• Theresa Banzuela, COTA/L
• Benjamin A. Baptist, D.D.S.

All providers in Chicago, IL · Physical Therapy Assistant in Illinois