Active NPI
Melissa M Stabrawa, PT, PHD
- Physical Therapist
- Highland Park, IL
National Provider Identifier
1770791063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 070007404
- Practice address
- 433 Havenwood Ave
Highland Park, IL 60035-5205 - Phone
- (847) 370-2262
- NPI assigned
- May 18, 2007
- 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 | PT 070007404 | IL | Primary |
Addresses
Primary practice location
433 Havenwood Ave
Highland Park, IL 60035-5205
Mailing address
433 Havenwood Ave
Highland Park, IL 60035-5205
Phone (847) 370-2262
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 070007404 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254441600000",
"number": "1770791063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 HAVENWOOD AVE",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600355205",
"telephone_number": "847-370-2262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 HAVENWOOD AVE",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600355205",
"telephone_number": "847-370-2262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STABRAWA",
"first_name": "MELISSA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PT, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2009-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "PT 070007404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.