Provider Demographics
NPI:1417076860
Name:BIEL, JOHN M (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:BIEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:3330 W 177TH ST
Practice Address - Street 2:SUITE 2B , 2ND FLOOR
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2184
Practice Address - Country:US
Practice Address - Phone:708-249-8346
Practice Address - Fax:708-249-8348
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070008984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL568080OtherMEDICARE GROUP NUMBER
IL1619908OtherBCBS IL GROUP NUMBER
IL567700OtherMEDICARE GROUP NUMBER
IL568150OtherMEDICARE GROUP NUMBER
IL567700OtherMEDICARE GROUP NUMBER
ILK18605Medicare PIN
INK48796Medicare PIN