Provider Demographics
NPI:1902841232
Name:APUADA, MICHAEL J (LPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:APUADA
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24014 W RENWICK RD
Mailing Address - Street 2:STE F
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-8708
Mailing Address - Country:US
Mailing Address - Phone:800-974-4378
Mailing Address - Fax:630-515-1536
Practice Address - Street 1:1431 N WESTERN AVE
Practice Address - Street 2:STE. #312
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-1797
Practice Address - Country:US
Practice Address - Phone:773-227-3232
Practice Address - Fax:773-227-2898
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070013185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00332139OtherRRMCARE
ILP00332139OtherRRMCARE
IL$$$$$$$$$001Medicaid