Individual provider Active NPI

Mamta Manchanda, LPT

  • Physical Therapist
  • Orland Park, IL
National Provider Identifier
1528254349
Registry record updated Sep 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
10723 Winterset Dr
Orland Park, IL 60467-1106
Phone
(708) 364-7087
NPI assigned
Sep 16, 2007
Last updated
Sep 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

10723 Winterset Dr
Orland Park, IL 60467-1106

Mailing address

15617 Somerglen CT
Orland Park, IL 60467-4585
Phone (708) 878-8342

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
070006613ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1189900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189900800000",
    "number": "1528254349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15617 SOMERGLEN CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674585",
            "telephone_number": "708-878-8342",
            "fax_number": "708-226-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10723 WINTERSET DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604671106",
            "telephone_number": "708-364-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHANDA",
        "first_name": "MAMTA",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-16",
        "last_updated": "2007-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2007; 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.