Provider Demographics
NPI:1255678272
Name:PYS, MICHAEL (DIPL OMT, NMT, LMT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:PYS
Suffix:
Gender:M
Credentials:DIPL OMT, NMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SHERMER RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5340
Mailing Address - Country:US
Mailing Address - Phone:847-770-3332
Mailing Address - Fax:
Practice Address - Street 1:1500 SHERMER RD
Practice Address - Street 2:SUITE 212
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-5340
Practice Address - Country:US
Practice Address - Phone:847-770-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.003840225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist