Individual provider Active NPI

Marian Graff, PT

  • Physical Therapist
  • Tinley Park, IL
National Provider Identifier
1619034808
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070011589 Issued in IL
Practice address
18215 Harlem Ave
Tinley Park, IL 60477-3609
Phone
(708) 444-2563
Fax
(708) 444-2769
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 070011589 IL Primary

Addresses

Primary practice location

18215 Harlem Ave
Tinley Park, IL 60477-3609

Mailing address

18215 Harlem Ave
Tinley Park, IL 60477-3609
Phone (708) 444-2563

Other identifiers 1

IdentifierTypeStateIssuer
070-011589OtherILPT STATE LICENSE #

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40685CAMDOrthodontics and Dentofacial Orthopedic Dentist
070011589ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy & Spine Institute Limited Partnership Physical Therapist Past Accepting new patients
DPT Holdings PLLC Physical Therapist PastSince Apr 1, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1619034808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18215 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773609",
            "telephone_number": "708-444-2563",
            "fax_number": "708-444-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18215 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773609",
            "telephone_number": "708-444-2563",
            "fax_number": "708-444-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAFF",
        "first_name": "MARIAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT STATE LICENSE #",
            "identifier": "070-011589",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.