Individual provider Active NPI

Mariam Husain, PT

  • Physical Therapist
  • Wheaton, IL
National Provider Identifier
1912542317
Registry record updated Nov 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.024444 Issued in IL
Practice address
1751 S Naperville Rd Ste 107
Wheaton, IL 60189-5896
Phone
(630) 682-9700
NPI assigned
Nov 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2019

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 070.024444 IL Primary

Addresses

Primary practice location

1751 S Naperville Rd Ste 107
Wheaton, IL 60189-5896

Mailing address

1830 Middleton Ave
Lisle, IL 60532-1536
Phone (630) 251-4045

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
070.024444ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Back and Joint PLLC CurrentSince Jan 19, 2023 Accepting new patients

Locations

640 E Saint Charles Rd
Ste 206
Carol Stream, IL 60188
Phone (630) 480-7155

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573344000000",
    "number": "1912542317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 MIDDLETON AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321536",
            "telephone_number": "630-251-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 S NAPERVILLE RD STE 107",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895896",
            "telephone_number": "630-682-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSAIN",
        "first_name": "MARIAM",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-10",
        "last_updated": "2019-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.024444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2019; 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.