Active NPI
Mathew Jacob
- Geriatric Physical Therapist
- Orland Park, IL
National Provider Identifier
1598025520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 05009554A
- Practice address
- 16228 Ryehill Cir
Orland Park, IL 60467-5392 - Phone
- (773) 817-1563
- NPI assigned
- May 24, 2012
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 05009554A | IN | Primary |
Addresses
Primary practice location
16228 Ryehill Cir
Orland Park, IL 60467-5392
Mailing address
16228 Ryehill Cir
Orland Park, IL 60467-5392
Phone (773) 817-1563
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05009554A | IN | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337817600000",
"number": "1598025520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16228 RYEHILL CIR",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604675392",
"telephone_number": "773-817-1563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16228 RYEHILL CIR",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604675392",
"telephone_number": "773-817-1563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "MATHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-24",
"last_updated": "2012-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IN",
"license": "05009554A",
"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 May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.