Active NPI
Physical Therapy Care
- Physical Therapist
- Oak Lawn, IL
National Provider Identifier
1992834014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PHYSICAL THERAPY CARE
- Practice address
- 4400 W 95TH St
Suite 404
Oak Lawn, IL 60453-2654 - Phone
- (708) 425-2345
- Fax
- (708) 425-3456
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Prof. Samweel Akhnoukh, RPT
- Title
- Owner
- Phone
- (708) 425-2345
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Primary |
Addresses
Primary practice location
4400 W 95TH St
Suite 404
Oak Lawn, IL 60453-2654
Mailing address
4400 W 95TH St
Suite 404
Oak Lawn, IL 60453-2654
Phone (708) 425-2345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 338865266001 | Medicaid | IL |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1992834014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 W 95TH ST",
"address_2": "SUITE 404",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532654",
"telephone_number": "708-425-2345",
"fax_number": "708-425-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 W 95TH ST",
"address_2": "SUITE 404",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532654",
"telephone_number": "708-425-2345",
"fax_number": "708-425-3456"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSICAL THERAPY CARE",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-05",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "AKHNOUKH",
"authorized_official_first_name": "SAMWEEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "708-425-2345",
"authorized_official_name_prefix": "Prof.",
"authorized_official_credential": "RPT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "338865266001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.