Active NPI
Mikalyn Marice Johnson
- Physical Therapist
- Franklin Park, IL
National Provider Identifier
1629721766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 10137 Grand Ave
Franklin Park, IL 60131-2548 - Phone
- (847) 451-7590
- NPI assigned
- Jan 29, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
10137 Grand Ave
Franklin Park, IL 60131-2548
Mailing address
1379 N Western Ave Apt 3a
Lake Forest, IL 60045-5401
Phone (405) 550-6126
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643414400000",
"number": "1629721766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1379 N WESTERN AVE APT 3A",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600455401",
"telephone_number": "405-550-6126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10137 GRAND AVE",
"city": "FRANKLIN PARK",
"state": "IL",
"postal_code": "601312548",
"telephone_number": "847-451-7590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MIKALYN",
"middle_name": "MARICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-29",
"last_updated": "2022-01-29",
"certification_date": "2022-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Franklin Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.