Individual provider Active NPI

Christopher Mlyniec

  • Physical Therapist
  • Des Plaines, IL
National Provider Identifier
1750557245
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070013572 Issued in IL
Practice address
200 W Howard St
Des Plaines, IL 60018
Phone
(847) 417-0963
NPI assigned
May 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2008

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 070013572 IL Primary

Addresses

Primary practice location

200 W Howard St
Des Plaines, IL 60018

Mailing address

9643 S Hamlin Ave
Evergreen Park, IL 60805-2949

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070013572ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1750557245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9643 S HAMLIN AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W HOWARD ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "60018",
            "telephone_number": "847-417-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLYNIEC",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.