Individual provider Active NPI

John Peter Slauson, PTA

  • Physical Therapy Assistant
  • Burr Ridge, IL
National Provider Identifier
1639375223
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
6801 High Grove Blvd
Burr Ridge, IL 60527-7585
Phone
(630) 920-2900
Fax
(630) 920-2453
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X IL Primary

Addresses

Primary practice location

6801 High Grove Blvd
Burr Ridge, IL 60527-7585

Mailing address

6600 S Brainard Ave
109
Countryside, IL 60525-4667
Phone (708) 482-3027

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

LicenseStateTypeSpecialty
160003390ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639375223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S BRAINARD AVE",
            "address_2": "109",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254667",
            "telephone_number": "708-482-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 HIGH GROVE BLVD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277585",
            "telephone_number": "630-920-2900",
            "fax_number": "630-920-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAUSON",
        "first_name": "JOHN",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • 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.