Individual provider Active NPI

Maureen Henske, PTA

  • Physical Therapy Assistant
  • Bloomingdale, IL
National Provider Identifier
1922528066
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.007812 Issued in IL
Practice address
165 S Bloomingdale Rd
Bloomingdale, IL 60108-1434
Phone
(630) 980-8700
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.007812 IL Primary

Addresses

Primary practice location

165 S Bloomingdale Rd
Bloomingdale, IL 60108-1434

Mailing address

109 Villa Way
Bloomingdale, IL 60108-1259
Phone (630) 404-6334

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
160.007812ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1922528066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 VILLA WAY",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081259",
            "telephone_number": "630-404-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S BLOOMINGDALE RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081434",
            "telephone_number": "630-980-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSKE",
        "first_name": "MAUREEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.007812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; 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.