Individual provider Active NPI

Ewa Podsiadlo Janiszewski, PTA

  • Physical Therapy Assistant
  • Chicago, IL
National Provider Identifier
1902135312
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160005307 Issued in IL
Practice address
122 S Michigan Ave
Suite 1770
Chicago, IL 60603-6191
Phone
(312) 939-4121
Fax
(312) 939-4121
NPI assigned
Dec 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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 160005307 IL Primary

Addresses

Primary practice location

122 S Michigan Ave
Suite 1770
Chicago, IL 60603-6191

Mailing address

122 S Michigan Ave
Suite 1770
Chicago, IL 60603-6191
Phone (312) 939-4121

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
160005307ILMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Millenium Park Medical Center, SC Past Accepting new patients
Rosenthal Clinic SC Past Accepting new patients

Organizations & group practices 2

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": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1902135312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE",
            "address_2": "SUITE 1770",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036191",
            "telephone_number": "312-939-4121",
            "fax_number": "312-939-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE",
            "address_2": "SUITE 1770",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036191",
            "telephone_number": "312-939-4121",
            "fax_number": "312-939-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANISZEWSKI",
        "first_name": "EWA",
        "middle_name": "PODSIADLO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160005307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.