Active NPI
Mithu Lijo
- Physical Therapist
- Chicago, IL
National Provider Identifier
1659058220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070026579
- Practice address
- 605 S Wolcott Avenue
Rehabilitation Services, 2ND Floor
Chicago, IL 60612 - Phone
- (312) 864-3600
- NPI assigned
- Jul 5, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 070026579 | IL | Primary |
Addresses
Primary practice location
605 S Wolcott Avenue
Rehabilitation Services, 2ND Floor
Chicago, IL 60612
Mailing address
25 W Randolph St Apt 2925
Chicago, IL 60601-3526
Phone (832) 472-8768
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070026579 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1659058220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 W RANDOLPH ST APT 2925",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606013526",
"telephone_number": "832-472-8768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 S WOLCOTT AVENUE",
"address_2": "REHABILITATION SERVICES, 2ND FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60612",
"telephone_number": "312-864-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIJO",
"first_name": "MITHU",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-05",
"last_updated": "2023-07-05",
"certification_date": "2023-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070026579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.