Individual provider Active NPI

Alfredo Gianan Aguilar Jr., PT

  • Physical Therapist
  • Washington, IL
National Provider Identifier
1649998113
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070016154 Issued in IL
Practice address
1201 Newcastle Rd
Washington, IL 61571-1243
Phone
(309) 444-3161
NPI assigned
Aug 19, 2022
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070016154 IL Primary

Addresses

Primary practice location

1201 Newcastle Rd
Washington, IL 61571-1243

Mailing address

821 Oakwood Rd
East Peoria, IL 61611-1652
Phone (309) 634-9378

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
070016154ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1649998113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111652",
            "telephone_number": "309-634-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NEWCASTLE RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615711243",
            "telephone_number": "309-444-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "ALFREDO",
        "middle_name": "GIANAN",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.

Verify at the official NPI Registry.