Active NPI
Lilli-Jayne R Mariano, P.T.
- Physical Therapist
- Crystal Lake, IL
National Provider Identifier
1740206374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-008545
- Practice address
- 200 E Congress Pkwy
Crystal Lake, IL 60014-6268 - Phone
- (815) 444-2930
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 070-008545 | IL | Primary |
Addresses
Primary practice location
200 E Congress Pkwy
Crystal Lake, IL 60014-6268
Mailing address
200 E Congress Pkwy
Crystal Lake, IL 60014-6268
Phone (815) 444-2930
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-008545 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centegra Primary Care LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Crystal Lake, IL
- NPI 1356883599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341273600000",
"number": "1740206374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E CONGRESS PKWY",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600146268",
"telephone_number": "815-444-2930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E CONGRESS PKWY",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600146268",
"telephone_number": "815-444-2930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIANO",
"first_name": "LILLI-JAYNE",
"middle_name": "R",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2012-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-008545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.