Active NPI
Luna X. Nino, P.T.
- Physical Therapy Clinic/Center
- St Charles, IL
National Provider Identifier
1861661050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 070010359
- Practice address
- 525 Tyler Rd Ste I
St Charles, IL 60174-3363 - Phone
- (630) 568-6123
- Fax
- (630) 584-0520
- NPI assigned
- Feb 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 070010359 | IL | Primary |
Addresses
Primary practice location
525 Tyler Rd Ste I
St Charles, IL 60174-3363
Mailing address
525 Tyler Rd Ste I
St Charles, IL 60174-3363
Phone (630) 584-2070
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070010359 | IL | MD | Physical Therapy Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756166400000",
"number": "1861661050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 TYLER RD STE I",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601743363",
"telephone_number": "630-584-2070",
"fax_number": "630-584-0520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 TYLER RD STE I",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601743363",
"telephone_number": "630-568-6123",
"fax_number": "630-584-0520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NINO",
"first_name": "LUNA",
"middle_name": "X.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-21",
"last_updated": "2025-08-26",
"certification_date": "2025-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "IL",
"license": "070010359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.