Active NPI
Russa Aussieker, PTA
- Physical Therapy Assistant
- Minonk, IL
National Provider Identifier
1497076103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160003378
- Practice address
- 201 Locust St
Minonk, IL 61760-1511 - Phone
- (309) 432-2557
- Fax
- (309) 432-3330
- NPI assigned
- Jun 16, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 160003378 | IL | Primary |
Addresses
Primary practice location
201 Locust St
Minonk, IL 61760-1511
Mailing address
550 Frontage Rd
Suite 2415
Northfield, IL 60093-1202
Phone (847) 441-5593
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 |
|---|---|---|---|
| 160003378 | IL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Outpatient Services Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Newcastle, WA
- NPI 1285909531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276646400000",
"number": "1497076103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 FRONTAGE RD",
"address_2": "SUITE 2415",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "600931202",
"telephone_number": "847-441-5593",
"fax_number": "847-441-0734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 LOCUST ST",
"city": "MINONK",
"state": "IL",
"postal_code": "617601511",
"telephone_number": "309-432-2557",
"fax_number": "309-432-3330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSSIEKER",
"first_name": "RUSSA",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-16",
"last_updated": "2010-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160003378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minonk, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.