Individual provider Active NPI

Elizabeth Ann Pandya, PT

  • Physical Therapist
  • Countryside, IL
National Provider Identifier
1922164474
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070 014675 Issued in IL
Practice address
100 W Plainfield Rd
Countryside, IL 60525
Phone
(708) 588-0833
Fax
(708) 588-0406
NPI assigned
Dec 29, 2006
Last updated
May 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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 014675 IL Primary

Addresses

Primary practice location

100 W Plainfield Rd
Countryside, IL 60525

Mailing address

100 W Plainfield Rd
Countryside, IL 60525-2869
Phone (708) 588-0833

Other practice location 1

11601 Brook Hill Dr
Orland Park, IL 60467-6033
Phone (312) 505-2318

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 014675ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Independence Through Conductive Education Inc Physical Therapist CurrentSince Nov 10, 2024 Accepting new patients

Locations

100 W Plainfield Rd
Countryside, IL 60525
Phone (708) 588-0833

100 W Plainfield Rd
Ste 100
Countryside, IL 60525
Phone (708) 588-0833

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1922164474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W PLAINFIELD RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605252869",
            "telephone_number": "708-588-0833",
            "fax_number": "708-588-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W PLAINFIELD RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "60525",
            "telephone_number": "708-588-0833",
            "fax_number": "708-588-0406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11601 Brook Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604676033",
            "country_code": "US",
            "telephone_number": "312-505-2318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070 014675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Countryside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.