Phillip G Statler, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

227.019355 Issued in IL

Practice address

1752 Windsor Rd
Loves Park, IL 61111-4280

Phone

(815) 977-3747

NPI assigned

Sep 20, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1851875439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10206 LEANA DR",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610736412",
            "telephone_number": "815-979-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 WINDSOR RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114280",
            "telephone_number": "815-977-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATLER",
        "first_name": "PHILLIP",
        "middle_name": "G",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.019355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tomasz A. Szerszow, M.D.

• Massage Therapist in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.