Ma Lizza Martinez Mendiola, RPT
Individual provider Active NPI Physical Therapist · Chatham, IL
NPI 1861826166 · NPPES record last updated Aug 23, 2013
Key facts
- NPI
- 1861826166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070016331 (IL)
- Practice address
- 106 Cottonwood Dr
Chatham, IL 62629-1047 - Phone
- (217) 220-1961
- NPI assigned
- Aug 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070016331 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070016331 | IL | Yes |
Addresses
Primary practice location
106 Cottonwood Dr
Chatham, IL 62629-1047
Mailing address
106 Cottonwood Dr
Chatham, IL 62629-1047
Phone (217) 220-1961
Other names
- Lizza Mendiola
Other providers in Chatham, IL
- Donna G Mattera
- Joanne Mayberry
- Jennifer Lynn McCabe
- Angela Faith McCormick
- Wendie Medina
- Micromedical Technologies, Inc
- Daj'Za Mitchell
- Amy Janine Moffat
- Miranda Joy Mogle
- Gustavo Mosquera
All providers in Chatham, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.