Mariel De Vera Visconde, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018847 Issued in IL

Practice address

3115 Lewis Ave
Zion, IL 60099-3099

Phone

(847) 746-3752

Fax

(847) 746-9144

NPI assigned

Jul 16, 2012

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

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

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.

• Center for Therapy and Wellness LLC

  • Physical Therapist
  • Island Lake, IL
  • NPI 1114785649
  Medicare reassignment NPD

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1629323696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E IRVING PARK RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601722048",
            "telephone_number": "630-439-0009",
            "fax_number": "630-439-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 LEWIS AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600993099",
            "telephone_number": "847-746-3752",
            "fax_number": "847-746-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCONDE",
        "first_name": "MARIEL",
        "middle_name": "DE VERA",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pankaj G Vashi, M.D.
• Jane Vaysberg, NP-C
• Irina Vigovskaya, PA-C
• Sherri Vinci
• Renee Vines
• Hannah E Wake, PHARMD
• Wal-Mart Stores, Inc.
• Genevieve Anne Waldschmidt, FPA-APN
• Walgreen Co
• Walgreen Co.

• Physical Therapist in Zion, IL
• Providers in Zion, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.