Active NPI
Adelino Mendoza
- Physical Therapist
- Peru, IL
National Provider Identifier
1679982490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-006974
- Practice address
- 3106 Carrie St
Peru, IL 61354-1494 - Phone
- (815) 993-3521
- NPI assigned
- Aug 6, 2014
- Last updated
- Aug 6, 2014
- 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 Therapist | 225100000X | 070-006974 | IL | Primary |
Addresses
Primary practice location
3106 Carrie St
Peru, IL 61354-1494
Mailing address
3106 Carrie St
Peru, IL 61354-1494
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 |
|---|---|---|---|
| 070-006974 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407283200000",
"number": "1679982490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3106 CARRIE ST",
"city": "PERU",
"state": "IL",
"postal_code": "613541494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3106 CARRIE ST",
"city": "PERU",
"state": "IL",
"postal_code": "613541494",
"telephone_number": "815-993-3521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "ADELINO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-06",
"last_updated": "2014-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-006974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peru, IL
- Amber Lynn Meagher
- Elizabeth Meier
- Peter J Meier, M.D.
- Mendota Community Hospital (Osf Healthcare - Medical Group - Plaza)
- Mendota Community Hospital (Osf Healthcare - Medical Group - Midtown)
- Maria Mendoza
- Monafae Jane Menerey, PT
- Timothy John Mertes, D.C.
- Patricia Michaels
- Heather Lynn Miller, CNM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.