Individual provider Active NPI

Mohini M Pandya, P.T.

  • Physical Therapist
  • Downers Grove, IL
National Provider Identifier
1902800477
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070010481 Issued in IL
Practice address
6800 Main St Ste 100
Downers Grove, IL 60516-3498
Phone
(630) 437-5175
Fax
(630) 437-5174
NPI assigned
Jun 12, 2005
Reactivated
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070010481 IL Primary

Addresses

Primary practice location

6800 Main St Ste 100
Downers Grove, IL 60516-3498

Mailing address

6800 Main St
Downers Grove, IL 60516-3493
Phone (630) 437-5175

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070010481ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1118534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1902800477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163493",
            "telephone_number": "630-437-5175",
            "fax_number": "630-437-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 MAIN ST STE 100",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163498",
            "telephone_number": "630-437-5175",
            "fax_number": "630-437-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "MOHINI",
        "middle_name": "M",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-12",
        "last_updated": "2012-09-14",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070010481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.