Individual provider Active NPI

Michelle Mariage

  • Physical Therapist
  • Elmhurst, IL
National Provider Identifier
1710150677
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
200 N Berteau Ave
Elmhurst, IL 60126-2966
Phone
(630) 782-4950
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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 IL Primary

Addresses

Primary practice location

200 N Berteau Ave
Elmhurst, IL 60126-2966

Mailing address

823 N Harvey Ave
Oak Park, IL 60302-1448

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
070.006195ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1710150677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 N HARVEY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N BERTEAU AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262966",
            "telephone_number": "630-782-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIAGE",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.