Individual provider Active NPI

Christian Mangio

  • Physical Therapy Assistant
  • Chicago, IL
National Provider Identifier
1780151290
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.008439 Issued in IL
Practice address
5109 N Kenneth Ave
Chicago, IL 60630-2622
Phone
(773) 251-4590
NPI assigned
Nov 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.008439 IL Primary

Addresses

Primary practice location

5109 N Kenneth Ave
Chicago, IL 60630-2622

Mailing address

5109 N Kenneth Ave
Chicago, IL 60630-2622
Phone (773) 251-4590

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
160.008439ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1780151290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 N KENNETH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302622",
            "telephone_number": "773-251-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 N KENNETH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302622",
            "telephone_number": "773-251-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIO",
        "first_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.008439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.