John Kissane, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070011551 Issued in IL

Practice address

18660 Graphics Drive
Tinley Park, IL 60477

Phone

(708) 390-3362

NPI assigned

Jan 7, 2009

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1659518082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18660 GRAPHICS DRIVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60477",
            "telephone_number": "708-390-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18660 GRAPHICS DRIVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60477",
            "telephone_number": "708-390-3362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6224 S Pulaski Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606294610",
            "country_code": "US",
            "telephone_number": "773-735-8200",
            "fax_number": "773-735-7451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSANE",
        "first_name": "JOHN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-07",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Tinley Park, IL
• Providers in Tinley Park, 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 30, 2019; 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.