Individual provider Active NPI

Mary M Nessinger

  • Physical Therapist
  • Palos Heights, IL
National Provider Identifier
1548590359
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070003571 Issued in IL
Practice address
12350 S Harlem Ave
Palos Heights, IL 60463-1425
Phone
(708) 684-3000
NPI assigned
Dec 30, 2009
Last updated
Dec 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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 070003571 IL Primary

Addresses

Primary practice location

12350 S Harlem Ave
Palos Heights, IL 60463-1425

Mailing address

6480 Springside Ave
Downers Grove, IL 60516-2418
Phone (630) 769-8734

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

State licenses

LicenseStateTypeSpecialty
070003571ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Past Accepting new patients

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": "1262131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1548590359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 SPRINGSIDE AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605162418",
            "telephone_number": "630-769-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12350 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631425",
            "telephone_number": "708-684-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESSINGER",
        "first_name": "MARY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-30",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070003571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; 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.