Mack Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.012671 Issued in IL

Legal business name

MACK PHYSICAL THERAPY LLC

Practice address

227 E Ontario St
Ste 201
Chicago, IL 60611-3385

Phone

(312) 527-2701

Fax

(312) 527-9202

NPI assigned

Feb 9, 2015

Last updated

Feb 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cori Mack, MSPTNPI 1578610259

Title

President

Phone

(312) 527-2701

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cori Mack, P.T

  • Physical Therapist
  • Chicago, IL
  • NPI 1578610259
  Medicare reassignment Care Compare group Authorized official
• Brynn Weimer, PT

  • Physical Therapist
  • Chicago, IL
  • NPI 1063723799
  Medicare reassignment Care Compare group NPD
• Lindsay Clare Paulsen, DPT

  • Physical Therapist
  • Chicago, IL
  • NPI 1114174364
  Medicare reassignment Care Compare group
• Lauren Marie Hooks, PT

  • Physical Therapist
  • Chicago, IL
  • NPI 1245759265
  Care Compare group
• Samit Shah, DPT

  • Physical Therapist
  • Chicago, IL
  • NPI 1467610121
  NPD
• Colin E Penn, DPT

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1932656824
  NPD (past)

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1720479041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 W NEWPORT AVE",
            "address_2": "APT 3E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571123",
            "telephone_number": "312-527-2701",
            "fax_number": "312-527-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 E ONTARIO ST",
            "address_2": "STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113385",
            "telephone_number": "312-527-2701",
            "fax_number": "312-527-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "CORI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-527-2701",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.012671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Elizabeth Macino, AGACNP-BC
• Peter William Macintosh, MD
• Theodore R Macis, DPT
• Phyllis Goldberg Maciulis, LCSW
• Robroy Henry Maciver
• Astrid K. Mack, MD
• Bianca McKenzie Mack
• Bonnie Mack, PHARMD
• Charlene Mack
• Clara Grace Mack, OTD

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.