Priya Josephselvam, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05010155A Issued in IN

Practice address

535 S Elm St
Itasca, IL 60143-2187

Phone

(630) 773-9416

NPI assigned

Feb 18, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587859200000",
    "number": "1508163080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 DUNLAY ST",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912132",
            "telephone_number": "319-294-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S ELM ST",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432187",
            "telephone_number": "630-773-9416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Compass Rd",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600268001",
            "country_code": "US",
            "telephone_number": "219-977-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPHSELVAM",
        "first_name": "PRIYA",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-18",
        "last_updated": "2020-04-26",
        "certification_date": "2020-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014910",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070020752",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010155A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cortney Johnson
• Jason Johnson
• Kalina Maria Johnson
• Gretchen Jones, PAC
• Joseph R. Sperlazzo D.D.S., P.C.
• Tiffany Marie Kanzler
• Brian Keane
• Jason Keeler
• Meghan Kleffman
• Olivia Knapik

• Physical Therapist in Itasca, IL
• Providers in Itasca, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2020; 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.