Individual provider Active NPI

Nya A Pauldon

  • Physical Therapy Clinic/Center
  • Sycamore, IL
National Provider Identifier
1558223214
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
070029655 Issued in IL
Practice address
2111 Midlands CT Ste G01
Sycamore, IL 60178-3125
Phone
(815) 748-8900
NPI assigned
Dec 1, 2025
Last updated
Dec 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 070029655 IL Primary

Addresses

Primary practice location

2111 Midlands CT Ste G01
Sycamore, IL 60178-3125

Mailing address

2111 Midlands CT Ste G01
Sycamore, IL 60178-3125

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
070029655ILMDPhysical Therapy Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1558223214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 MIDLANDS CT STE G01",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 MIDLANDS CT STE G01",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783125",
            "telephone_number": "815-748-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULDON",
        "first_name": "NYA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070029655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.