Michelle R Archibald, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.017370 Issued in IL

Practice address

6775 Prosperi Dr
Tinley Park, IL 60477-4789

Phone

(708) 429-1260

Fax

(708) 429-9107

NPI assigned

Apr 20, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Michelle Laughlin Former name

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": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1871850370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19015 S. JODI ROAD",
            "address_2": "SUITE A",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488534",
            "telephone_number": "708-478-1414",
            "fax_number": "708-478-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6775 PROSPERI DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774789",
            "telephone_number": "708-429-1260",
            "fax_number": "708-429-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBALD",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.017370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LAUGHLIN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anthony L Buckles MD
• Ashley Dajay Anthony
• Kersey H Antia, PHD
• Mina Milad Antonuos
• Lori Arambula, BCBA
• Dy'Jhanik Armfield
• Aretha Armstrong, LPC
• Kandace L Arnold
• Robert Arnott, RD
• Gabriela Arteaga, MOTR/L

• Physical Therapist in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.