OrganizationActive
Melissa Jacob
NPI 1205330628 · Physical Therapy Clinic/Center · Northlake, IL
Provider details
- NPI number
- 1205330628
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kent Lattanzi, Human Resource Assistant(410) 667-7200
- License
- 070022999 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
420 N Wolf Rd
Northlake, IL 60164-1670
Phone: (708) 562-4300
Street-level locationGet directions
Mailing address
3n464 Patricia Ln
Elmhurst, IL 60126-1210
Registry dates
- Enumerated
- 2018-03-20
- Last updated
- 2018-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.