Maryann Gilruth, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160000277 Issued in IL

Practice address

605 S Edward Dr
Romeoville, IL 60446-6507

Phone

(630) 863-7772

NPI assigned

Sep 5, 2012

Last updated

Sep 5, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1922357938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 SUMMIT LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401619",
            "telephone_number": "630-253-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S EDWARD DR",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604466507",
            "telephone_number": "630-863-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILRUTH",
        "first_name": "MARYANN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160000277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Romeoville, IL
• Providers in Romeoville, 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 Sep 5, 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.