Mary Samulak, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.007492 Issued in IL

Practice address

3703 W Lake Ave
Suite200
Glenview, IL 60026-5823

Phone

(847) 998-1188

NPI assigned

Jun 29, 2016

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

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1871944934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W STONEGATE BLVD",
            "address_2": "APT 219",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051045",
            "telephone_number": "269-964-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 W LAKE AVE",
            "address_2": "SUITE200",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265823",
            "telephone_number": "847-998-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMULAK",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.007492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Samikkannu, MD
• Daniel G. Samo, MD
• Britne Sampang, PTA
• Christie Marie Samrai, DMD
• Daniel Samuel, LSW
• San Pablo Health Center
• Brenly Marie Sanchez Cintron, PHARM D
• Carmela Sanchez, PA
• Jana Angela Sanchez
• Leo Franco Sanchez, PHYSICAL THERAPIST

• Physical Therapy Assistant in Glenview, IL
• Providers in Glenview, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.