Mai Ahmed, PHYSICAL THERAPIST

Individual provider Active NPI Physical Therapist · Munster, IN

NPI 1780336552 · NPPES record last updated Sep 17, 2024

Key facts

NPI
1780336552
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.026363 (IL)
Practice address
8159 Calumet Ave
Munster, IN 46321-1701
Phone
(219) 836-2800
NPI assigned
Jan 24, 2022
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physical Therapy PC (12 clinicians)

Practice addresses (Care Compare)

14474 S la Grange Rd
Orland Park, IL 60462-2506
Phone 63092046706

8159 Calumet Ave
Munster, IN 46321-1701
Phone (630) 920-4670

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IL, IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220225002377 IL Practitioner - Physical Therapist in Private Practice 5496149973 Reassigns benefits to 1 organization
I20220302001844 IN Practitioner - Physical Therapist in Private Practice 5496149973 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070.026363ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy PC Physical Therapist Current
since Jan 1, 2022
Accepting new patients

Locations

570 Village Center Dr
Ste 205
Burr Ridge, IL 60527

1850 W Winchester Rd
Ste 223
Libertyville, IL 60048
Phone (847) 680-3020

14474 S La Grange Rd
Orland Park, IL 60462
Phone (708) 460-8080

8159 Calumet Ave
Munster, IN 46321
Phone (219) 836-2800

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.026363 IL Yes

Addresses

Primary practice location

8159 Calumet Ave
Munster, IN 46321-1701

Mailing address

570 Village Center Dr Ste 205
Burr Ridge, IL 60527-4526
Phone (630) 920-4670

Other providers in Munster, IN

All providers in Munster, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.