Joseph Romero Dimatulac, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

21536 Wolf Rd
Mokena, IL 60448-2089

Phone

(815) 464-4418

NPI assigned

Aug 29, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1962287797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOGAN CT",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604902133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21536 WOLF RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482089",
            "telephone_number": "815-464-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMATULAC",
        "first_name": "JOSEPH",
        "middle_name": "ROMERO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dialysis Centers of America - Illinois, Inc.
• Angelica Marie Diaz, FNP-C
• Dieringer Chiropractic Health Clinic, LTD.
• Robert J Dieringer, DC
• Nichole Marie Dimaria, FNP
• Jessica Dineen, RSA
• Emili Marie Dobronics, DDS
• Lana Dobson
• Kyle Dodge, DPT
• Katherine F Dolph

• Physical Therapy Assistant in Mokena, IL
• Providers in Mokena, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.