Individual provider Active NPI

Earl Justin Suico, PTA

  • Physical Therapy Assistant
  • Elk Grove Village, IL
National Provider Identifier
1881567212
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.006852 Issued in IL
Practice address
901 Biesterfield Rd Ste 308
Elk Grove Village, IL 60007-7324
Phone
(847) 437-9889
NPI assigned
Sep 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.006852 IL Primary

Addresses

Primary practice location

901 Biesterfield Rd Ste 308
Elk Grove Village, IL 60007-7324

Mailing address

1461 W Summerdale Ave Apt 1B
Chicago, IL 60640-2149
Phone (331) 645-0936

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

LicenseStateTypeSpecialty
160.006852ILMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Sports Medicine & Orthopaedic Surgical Specialists, LTD. PastSince Sep 28, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1881567212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 W SUMMERDALE AVE APT 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402149",
            "telephone_number": "331-645-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BIESTERFIELD RD STE 308",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077324",
            "telephone_number": "847-437-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUICO",
        "first_name": "EARL",
        "middle_name": "JUSTIN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.006852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.