Individual provider Active NPI

Yvonne Mlynarczyk, PT

  • Physical Therapist
  • Lisle, IL
National Provider Identifier
1740378918
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070003812 Issued in IL
Practice address
4513 Lincoln Ave Ste 105a
Lisle, IL 60532
Phone
(331) 223-9800
Fax
(773) 337-9106
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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 070003812 IL Primary

Addresses

Primary practice location

4513 Lincoln Ave Ste 105a
Lisle, IL 60532

Mailing address

4513 Lincoln Ave Ste 105a
Lisle, IL 60532-1290
Phone (331) 223-9800

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

LicenseStateTypeSpecialty
070003812ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Be Fit Physical Therapy & Pilates, LTD Physical Therapist CurrentSince Nov 19, 2012 Accepting new patients
Advanced Rehabilitation Clinics, Inc Physical Therapist PastSince Oct 7, 1996 Accepting new patients
Chicago Institute of Neurosurgery & Neuroresearch Past Accepting new patients

Locations

1027 Burlington Ave
Downers Grove, IL 60515
Phone (630) 946-4008

4934 Main St
Downers Grove, IL 60515
Phone (630) 964-4008

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1740378918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 LINCOLN AVE STE 105A",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321290",
            "telephone_number": "331-223-9800",
            "fax_number": "773-337-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 LINCOLN AVE STE 105A",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "60532",
            "telephone_number": "331-223-9800",
            "fax_number": "773-337-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLYNARCZYK",
        "first_name": "YVONNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070003812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.