{"npi":"1558467613","type":"NPI-1","status":"active","name":{"display":"Mary Formea Pt","other":[],"first":"MARY","last":"FORMEA","middle":"K","credential":"PT"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"IL","license":"070-015175"}]},"addresses":[{"purpose":"LOCATION","street_1":"1221 N HIGHLAND AVE","city":"AURORA","state":"IL","postal_code":"605061404","country_code":"US","phone":"6308598700"},{"purpose":"MAILING","street_1":"2357 SEQUOIA DR","city":"AURORA","state":"IL","postal_code":"605066222","country_code":"US","phone":"6308596800"}],"license":{"state":"IL","number":"070-015175"},"identifiers":[{"type_code":"01","label":"Other","value":"0451514334","state":"IL","issuer":"BCBS PROVIDER ID#"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20061215000339","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"IL","pac_id":"1850358318"}]},"enumeration_date":"2006-09-16","last_updated":"2021-11-22","_meta":{"source":"NPPES","snapshot_date":"2021-11-22","doc_url":"https://findmynpi.com/api"}}