Individual provider Active NPI

Lydia T Novak, PT

  • Physical Therapist
  • Orland Park, IL
National Provider Identifier
1942373048
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
14640 John Humphrey Dr
Suite 102
Orland Park, IL 60462-5854
Phone
(708) 403-5199
Fax
(708) 403-7274
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary
Sports Physical Therapist 2251S0007X IL
Orthopedic Physical Therapist 2251X0800X IL

Addresses

Primary practice location

14640 John Humphrey Dr
Suite 102
Orland Park, IL 60462-5854

Mailing address

14640 John Humphrey Dr
Suite 102
Orland Park, IL 60462-5854
Phone (708) 403-5199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081025000074 IL Practitioner - Physical Therapist in Private Practice 4486712023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Chicago, Pritzker School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orland Physical Therapy LTDGroup PAC ID 4284985409, 5 clinicians

Practice addresses (Care Compare)

14640 John Humphrey Dr
Suite 102
Orland Park, IL 60462-5852
Phone (708) 403-5199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070011693ILMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orland Physical Therapy LTD Physical Therapist CurrentSince Aug 30, 2018 Accepting new patients

Locations

14640 John Humphrey Dr
Ste 102
Orland Park, IL 60462
Phone (708) 227-2771

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1942373048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14640 JOHN HUMPHREY DR",
            "address_2": "SUITE 102",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604625854",
            "telephone_number": "708-403-5199",
            "fax_number": "708-403-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14640 JOHN HUMPHREY DR",
            "address_2": "SUITE 102",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604625854",
            "telephone_number": "708-403-5199",
            "fax_number": "708-403-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "LYDIA",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.