Active NPI
Ty Stetler
- Orthopedic Physical Therapist
- Evanston, IL
National Provider Identifier
1528791209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- Practice address
- 839 Dodge Ave
Evanston, IL 60202-1552 - Phone
- (857) 859-6240
- Fax
- (847) 603-7477
- NPI assigned
- Jul 8, 2022
- Last updated
- Jul 8, 2022
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | NU | Primary |
Addresses
Primary practice location
839 Dodge Ave
Evanston, IL 60202-1552
Mailing address
839 Dodge Ave
Evanston, IL 60202-1552
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skillz Physical Therapy LLC | Orthopedic | Current | Accepting new patients |
Locations
839 Dodge Ave
Evanston, IL 60202
Phone (847) 859-6240
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657238400000",
"number": "1528791209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "839 DODGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602021552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "839 DODGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602021552",
"telephone_number": "857-859-6240",
"fax_number": "847-603-7477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STETLER",
"first_name": "TY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-08",
"last_updated": "2022-07-08",
"certification_date": "2022-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.