Mary G Conway, PT

Key facts

NPI

1497795629

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

070005954 (IL)

Practice address

71 W 156TH St
Suite 208
Harvey, IL 60426-4260

Phone

(708) 331-3748

Fax

(708) 331-3605

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

Yes

Organizations & group practices 6

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.

• Ucm Medical Group Sub, LLC Family Medicine Physician · Harvey, IL · NPI 1467442293
  Medicare reassignment Care Compare group NPD IL
• Chicago Institute of Neurosurgery & Neuroresearch Neurological Surgery Physician · Chicago, IL · NPI 1326099391
  NPD (past)
• Cressa Perish MD SC Family Medicine Physician · Flossmoor, IL · NPI 1467553743
  NPD (past)
• Hand and Orthopaedic Surgery Center Inc Specialist · Oakbrook Terrace, IL · NPI 1881902583
  NPD (past)
• Hinsdale Sport and Spine Therapy Physical Therapist · Westmont, IL · NPI 1922186139
  NPD (past) PHYSICAL THERAPIST
• Kirk Center for Healthy Living, PC Physical Therapy Clinic/Center · Homer Glen, IL · NPI 1124065743
  NPD (past) PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ucm Medical Group Sub LLC (101 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Mary G Evans Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 21, 2013.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1497795629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604434119",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 W 156TH ST",
            "address_2": "SUITE 208",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264260",
            "telephone_number": "708-331-3748",
            "fax_number": "708-331-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "MARY",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070005954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "EVANS",
            "middle_name": "G",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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