Active NPI
Timothy Co
- Physical Therapy Assistant
- Northlake, IL
National Provider Identifier
1871012443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160007830
- Practice address
- 401 W Lake St
Northlake, IL 60164-2435 - Phone
- (847) 644-9714
- NPI assigned
- Sep 15, 2017
- Reactivated
- Jan 16, 2019
- Last updated
- Jan 16, 2019
- Sex
- Male
- 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 Assistant | 225200000X | 160007830 | IL | Primary |
Addresses
Primary practice location
401 W Lake St
Northlake, IL 60164-2435
Mailing address
1288 Perry St Apt 11
Des Plaines, IL 60016-3359
Phone (847) 644-9714
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160007830 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1871012443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1288 PERRY ST APT 11",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600163359",
"telephone_number": "847-644-9714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W LAKE ST",
"city": "NORTHLAKE",
"state": "IL",
"postal_code": "601642435",
"telephone_number": "847-644-9714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CO",
"first_name": "TIMOTHY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-15",
"last_updated": "2019-01-16",
"deactivation_date": "2018-10-11",
"reactivation_date": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160007830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northlake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.