Individual provider Active NPI

Bernadeth Sapalo Costes, PTA

  • Physical Therapy Assistant
  • Skokie, IL
National Provider Identifier
1922716562
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160008177 Issued in IL
Practice address
9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703
Phone
(847) 983-8841
Fax
(888) 401-3644
NPI assigned
Nov 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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 160008177 IL Primary

Addresses

Primary practice location

9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703

Mailing address

9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703
Phone (847) 983-8841

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
160008177ILMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dependable Care Staffing, LLC Physical Therapy Assistant CurrentSince Nov 20, 2022 Accepting new patients

Locations

9933 Lawler Ave
Ste 206B
Skokie, IL 60077
Phone (847) 983-8417

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": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1922716562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 206B",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-983-8841",
            "fax_number": "888-401-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 206B",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-983-8841",
            "fax_number": "888-401-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTES",
        "first_name": "BERNADETH",
        "middle_name": "SAPALO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160008177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.