Living Well Physical Therapy Inc

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

070.007536 Issued in IL

Legal business name

LIVING WELL PHYSICAL THERAPY INC

Practice address

450 N Seymour Ave
Mundelein, IL 60060-1835

Phone

(847) 949-4262

Fax

(847) 949-8526

NPI assigned

Aug 30, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda Kay Zagula, M.P.T.NPI 1881626349

Title

Owner/President

Phone

(847) 651-4419

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brenda Kay Zagula, M.P.T.

  • Physical Therapist
  • Mundelein, IL
  • NPI 1881626349
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1811181191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 WRENS GATE",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601268",
            "telephone_number": "847-651-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N SEYMOUR AVE",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601835",
            "telephone_number": "847-949-4262",
            "fax_number": "847-949-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "ZAGULA",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "847-651-4419",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070.007536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Mundelein, IL
• Providers in Mundelein, IL by specialty
• Orthopedic Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.