Mia Panaligan Combenido, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.019968 Issued in IL

Practice address

6 Birkdale CT
Lake in the Hills, IL 60156-5831

Phone

(773) 968-4871

NPI assigned

Feb 16, 2018

Sex

Female

Sole proprietor

Yes

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

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Av360 LLC

  • Health Educator
  • Algonquin, IL
  • NPI 1013515501

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1710487608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BIRKDALE CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565831",
            "telephone_number": "773-968-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BIRKDALE CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565831",
            "telephone_number": "773-968-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBENIDO",
        "first_name": "MIA",
        "middle_name": "PANALIGAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.019968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Chambers, LPC
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• Gregory B. Cook, DC
• Costco Wholesale Corporation

• Physical Therapist in Lake in the Hills, IL
• Providers in Lake in the Hills, 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 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.