Connie Myjak, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Practice address

4421 S Nancy Dr
Crystal Lake, IL 60014-6464

Phone

(815) 444-9746

NPI assigned

Nov 10, 2006

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 and National Provider Directory roles.

• TCM Physical Therapy, Inc.

  • Pediatric Physical Therapist
  • Crystal Lake, IL
  • NPI 1093085060

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619048071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 S NANCY DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 S NANCY DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146464",
            "telephone_number": "815-444-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYJAK",
        "first_name": "CONNIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amitha Mushyam, M.D.
• Myers Counseling Group
• Myers Counseling Group, LTD
• Janet N. Myers, LCSW
• Mark A Myers, LCSW
• Dominique Nagel
• Benjamin Jay Nager, MD
• Jacqueline Nakamura, LMT
• Nancy Peterson Walz, LCSW, P.C.
• Ranjana Nath, MD

• Pediatric Physical Therapist in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Pediatric Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.