Active NPI
Adam Haslag, PTA
- Physical Therapy Assistant
- Glenview, IL
National Provider Identifier
1497322291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2012025875
- Practice address
- 2600 Compass Rd
Glenview, IL 60026-8001 - Phone
- (877) 787-3430
- NPI assigned
- Jun 9, 2021
- 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 | 2012025875 | MO | Primary |
Addresses
Primary practice location
2600 Compass Rd
Glenview, IL 60026-8001
Mailing address
9419 Stoney Gap Rd
Jefferson City, MO 65101-9517
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2012025875 | Other | MO | MO BOARD OF HEALING ARTS |
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 |
|---|---|---|---|
| 2012025875 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1497322291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9419 STONEY GAP RD",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651019517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 COMPASS RD",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268001",
"telephone_number": "877-787-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASLAG",
"first_name": "ADAM",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-09",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2012025875",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO BOARD OF HEALING ARTS",
"identifier": "2012025875",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.