Organization Active NPI

Maayo Corp

  • Physical Therapy Clinic/Center
  • Chicago, IL
National Provider Identifier
1710726534
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MAAYO CORP
Practice address
1456 E 69TH PL
Chicago, IL 60637-4862
Phone
(773) 571-7927
NPI assigned
May 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sheila Villacampa, PTNPI 1720107147
Title
Secretary
Phone
(773) 571-7927

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1456 E 69TH PL
Chicago, IL 60637-4862

Mailing address

1456 E 69TH PL
Chicago, IL 60637-4862

Other identifiers 1

IdentifierTypeStateIssuer
1720107147MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251024003281 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8426546987 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1710726534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 E 69TH PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606374862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 E 69TH PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606374862",
            "telephone_number": "773-571-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAAYO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "VILLACAMPA",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "773-571-7927",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720107147",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.