NPIMap

Individual provider Active NPI

Terry Michael Ramos Rosal, P.T.

  • Physical Therapist
  • Lisle, IL
National Provider Identifier
1518285048
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031134 Issued in NY
Practice address
4621 Wedgewood Court
Lisle, IL 60532
Phone
(630) 999-1040
Fax
(630) 925-7412
NPI assigned
May 7, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070022971 IL
Physical Therapist 225100000X 031134 NY Primary

Addresses

Primary practice location

4621 Wedgewood Court
Lisle, IL 60532

Mailing address

386 Clubhouse St
Bolingbrook, IL 60490

Other names 1

  • Terry Ramos Rosal Professional name

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
070022971ILMDPhysical Therapist
031134NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1518285048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 CLUBHOUSE ST",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 WEDGEWOOD COURT",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "60532",
            "telephone_number": "630-999-1040",
            "fax_number": "630-925-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSAL",
        "first_name": "TERRY MICHAEL",
        "middle_name": "RAMOS",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-07",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070022971",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRY",
            "last_name": "ROSAL",
            "middle_name": "RAMOS",
            "credential": "P.T.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; 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.