Individual provider Active NPI

Mayumi Barrack

  • Physical Therapist
  • Hinsdale, IL
National Provider Identifier
1487088795
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070020078 Issued in IL
Practice address
201 E Ogden Ave
Suite 218
Hinsdale, IL 60521-3633
Phone
(630) 581-5097
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 070020078 IL Primary

Addresses

Primary practice location

201 E Ogden Ave
Suite 218
Hinsdale, IL 60521-3633

Mailing address

201 E Ogden Ave
Suite 218
Hinsdale, IL 60521-3633
Phone (630) 581-5097

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
070020078ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1487088795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E OGDEN AVE",
            "address_2": "SUITE 218",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213633",
            "telephone_number": "630-581-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E OGDEN AVE",
            "address_2": "SUITE 218",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213633",
            "telephone_number": "630-581-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRACK",
        "first_name": "MAYUMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070020078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.