Active NPI
Thomas Novak
- Physical Therapy Assistant
- Alsip, IL
National Provider Identifier
1669316170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160.010293
- Practice address
- 12820 S Blossom Dr
Alsip, IL 60803-2764 - Phone
- (708) 567-5922
- NPI assigned
- Apr 15, 2026
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 160.010293 | IL | Primary |
Addresses
Primary practice location
12820 S Blossom Dr
Alsip, IL 60803-2764
Mailing address
12820 S Blossom Dr
Alsip, IL 60803-2764
Phone (708) 567-5922
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 |
|---|---|---|---|
| 160.010293 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1669316170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12820 S BLOSSOM DR",
"city": "ALSIP",
"state": "IL",
"postal_code": "608032764",
"telephone_number": "708-567-5922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12820 S BLOSSOM DR",
"city": "ALSIP",
"state": "IL",
"postal_code": "608032764",
"telephone_number": "708-567-5922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVAK",
"first_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-15",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.010293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alsip, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.