Active NPI
Mark Elton Lao Ong
- Physical Therapist
- Belvidere, IL
National Provider Identifier
1871144303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070021359
- Practice address
- 2250 Pearl St
Belvidere, IL 61008-6022 - Phone
- (815) 544-0358
- NPI assigned
- Sep 25, 2019
- Last updated
- Sep 25, 2019
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225100000X | 070021359 | IL | Primary |
Addresses
Primary practice location
2250 Pearl St
Belvidere, IL 61008-6022
Mailing address
3761 Harwood LN
Rockford, IL 61114-5299
Phone (858) 275-4132
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 |
|---|---|---|---|
| 070021359 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569369600000",
"number": "1871144303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3761 HARWOOD LN",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611145299",
"telephone_number": "858-275-4132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 PEARL ST",
"city": "BELVIDERE",
"state": "IL",
"postal_code": "610086022",
"telephone_number": "815-544-0358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ONG",
"first_name": "MARK ELTON",
"middle_name": "LAO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-25",
"last_updated": "2019-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070021359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belvidere, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.