Disha Kunal Shukla, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070019565 Issued in IL

Practice address

4505 W 95TH St
Oak Lawn, IL 60453-2621

Phone

(708) 229-9828

Fax

(708) 422-0914

NPI assigned

Jun 14, 2013

Last updated

Jun 14, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Therapy Providers of America Inc.

  • Physical Therapist
  • Oak Lawn, IL
  • NPI 1447396270
  NPD (past)

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1558700344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532621",
            "telephone_number": "708-229-9828",
            "fax_number": "708-422-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532621",
            "telephone_number": "708-229-9828",
            "fax_number": "708-422-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "DISHA",
        "middle_name": "KUNAL",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shreevarsha Shreekumar
• James C. Shroba, D.C.
• Adem Shuaipaj, DO
• Diwante Jamal Shuford, MD
• Jennifer Naa Adoley Shuford, MD
• Maya Shvarts
• Irfan Hasan Siddiqui, MD
• Omar A Siddiqui, M.D.
• Saad Ahmed Siddiqui, MD
• Laurie Heintz Siegel, LCPC, CADC, MISAII

• Physical Therapist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; 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.