Active NPI
Mervin Tan Inot
- Physical Therapist
- Streator, IL
National Provider Identifier
1972215952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2002 E Main St
Streator, IL 61364-3192 - Phone
- (815) 673-7477
- NPI assigned
- Dec 21, 2022
- 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 | Primary |
Addresses
Primary practice location
2002 E Main St
Streator, IL 61364-3192
Mailing address
115 W. Pine St.
Apt 2 Down
Chillicothe, IL 61523
Phone (929) 383-3057
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1972215952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 W. PINE ST.",
"address_2": "APT 2 DOWN",
"city": "CHILLICOTHE",
"state": "IL",
"postal_code": "61523",
"telephone_number": "929-383-3057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 E MAIN ST",
"city": "STREATOR",
"state": "IL",
"postal_code": "613643192",
"telephone_number": "815-673-7477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INOT",
"first_name": "MERVIN",
"middle_name": "TAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-21",
"last_updated": "2022-12-21",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Streator, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.