Active NPI
Michael Ladra Marquez
- Physical Therapist
- Hines, IL
National Provider Identifier
1932454634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070018902
- Practice address
- 5000 South 5TH Ave.
Edward Hines Jr. VA Hospital
Hines, IL 60141 - Phone
- (708) 202-3800
- NPI assigned
- Jul 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070018902 | IL | Primary |
Addresses
Primary practice location
5000 South 5TH Ave.
Edward Hines Jr. VA Hospital
Hines, IL 60141
Mailing address
5000 South 5TH Ave.
Edward Hines Jr. VA Hospital
Hines, IL 60141
Phone (708) 202-3800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070018902 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342569600000",
"number": "1932454634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 SOUTH 5TH AVE.",
"address_2": "EDWARD HINES JR. VA HOSPITAL",
"city": "HINES",
"state": "IL",
"postal_code": "60141",
"telephone_number": "708-202-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 SOUTH 5TH AVE.",
"address_2": "EDWARD HINES JR. VA HOSPITAL",
"city": "HINES",
"state": "IL",
"postal_code": "60141",
"telephone_number": "708-202-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARQUEZ",
"first_name": "MICHAEL",
"middle_name": "LADRA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-18",
"last_updated": "2012-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070018902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.