Individual provider Active NPI

Evie Rosado, LMT

  • Massage Therapist
  • Joliet, IL
National Provider Identifier
1912538786
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.015397 Issued in IL
Practice address
711 E Jackson St
Joliet, IL 60432-2540
Phone
(815) 325-2376
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227.015397 IL Primary

Addresses

Primary practice location

711 E Jackson St
Joliet, IL 60432-2540

Mailing address

1516 Phoenix LN
Joliet, IL 60431-8417
Phone (815) 325-2376

Other practice location 1

115 N Marion St Ste 8
Oak Park, IL 60301-1503
Phone (773) 915-3683

Other identifiers 3

IdentifierTypeStateIssuer
MA89150OtherFLFL DEPARTMENT OF HEALTH
227.015397OtherILILDPH MASSAGE THERAPIST LICENSE NUMBER
MT21906775OtherININDIANA PROFESSIONAL LICENSING AGENCY

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
227.015397ILMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Palmgren Acupuncture Center Inc. Past 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": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1912538786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 PHOENIX LN",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318417",
            "telephone_number": "815-325-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E JACKSON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322540",
            "telephone_number": "815-325-2376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 N Marion St Ste 8",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603011503",
            "country_code": "US",
            "telephone_number": "773-915-3683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSADO",
        "first_name": "EVIE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.015397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL DEPARTMENT OF HEALTH",
            "identifier": "MA89150",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILDPH  MASSAGE THERAPIST LICENSE NUMBER",
            "identifier": "227.015397",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL LICENSING AGENCY",
            "identifier": "MT21906775",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.