Mena Loka Sr.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.007565 Issued in IL

Practice address

6404 Nature Dr
Oak Forest, IL 60452

Phone

(708) 477-1705

NPI assigned

Mar 20, 2017

Last updated

Mar 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1902347297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 NATURE DR",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522629",
            "telephone_number": "708-477-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 NATURE DR",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "60452",
            "telephone_number": "708-477-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOKA",
        "first_name": "MENA",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.007565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen E Licata, M.S., CCC-SLP/L
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• Physical Therapy Assistant in Oak Forest, IL
• Providers in Oak Forest, 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 Mar 20, 2017; 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.