Emmanuel Bistas, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

227001888 Issued in IL

Practice address

40 E Huron St Ste 200
Chicago, IL 60611-5244

Phone

(312) 493-1840

NPI assigned

Apr 1, 2024

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": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1861243206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21385 GEORGETOWN RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233009",
            "telephone_number": "312-493-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E HURON ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115244",
            "telephone_number": "312-493-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISTAS",
        "first_name": "EMMANUEL",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227001888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Eduardo Bisono, MD
• Kyle Alan Bisping, DPT
• James Bissell, MA, LCPC
• Bruce Marc Bissonnette, M.D.
• Mei Lin Zimmerman Bissonnette, MD
• Tracy Bisterfeldt, PSY.D.
• Ananya Biswas, MD
• Alyse Biszewski, M.S.W
• Bite Club
• Bite Size Therapy PLLC

• Massage Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.