Michelle L Quillin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070014043 Issued in IL

Practice address

635 Executive Dr
Willowbrook, IL 60527-5603

Phone

(815) 455-6630

Fax

(630) 455-6631

NPI assigned

Sep 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michelle L Larsen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Athletic and Therapeutic Institute of Naperville, LLC

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  • NPI 1144331794
  NPD (past)
• Athletic and Therapeutic Institute of Naperville, LLC

  • Physical Therapist
  • Winfield, IL
  • NPI 1265597157
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1942392469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 EXECUTIVE DR",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275603",
            "telephone_number": "815-455-6630",
            "fax_number": "630-455-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLIN",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00931527",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LARSEN",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Precise Bioscience, LLC
• Primary Health Care LLC
• Pure Wellness Clinic, PLLC
• Christy M Pyzik, APN, FNP-BC
• Quest Fitness, LTD.
• R M Bueser MD LTD
• Bart Hubert Rafacz, APN
• Huyen Rago
• Huzefa Raja, PHARMD
• Zuly B Ramirez, M.A., LPC

• Physical Therapist in Willowbrook, IL
• Providers in Willowbrook, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.