Elizabeth Faye Putman, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160007154 Issued in IL

Practice address

10300 Village Cir Dr
Peace Village
Palos Park, IL 60464

Phone

(708) 361-3683

NPI assigned

Apr 11, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1972000479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14617 S ARBORETUM DRIVE",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "60491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 VILLAGE CIR DR",
            "address_2": "PEACE VILLAGE",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "60464",
            "telephone_number": "708-361-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTMAN",
        "first_name": "ELIZABETH",
        "middle_name": "FAYE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160007154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J. Porter, M.D.
• Danielle Patrice Poulos, FNP-C
• Robert C Prentice, D.O.
• Pride in Care LLC
• Pulmonary and Critical Care Consultants, S.C.
• Timothy Quinlan Jr., PHARMD, RPH
• Steven Jay Quinn, M.D.
• Sabir Muhammad Rahmanny, MD
• Chirag Rajyaguru
• Ravi Kumar Ramana, D.O.

• Physical Therapy Assistant in Palos Park, IL
• Providers in Palos Park, 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 Apr 11, 2018; 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.