Active NPI
Nancy J Walsh, P.T.
- Geriatric Physical Therapist
- Chicago Heights, IL
National Provider Identifier
1003046251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 070011814
- Practice address
- 100 197TH PL
Chicago Heights, IL 60411-7539 - Phone
- (708) 755-3020
- NPI assigned
- Jul 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 070011814 | IL | Primary |
Addresses
Primary practice location
100 197TH PL
Chicago Heights, IL 60411-7539
Mailing address
3403 W Oakhill Dr
Crete, IL 60417-1965
Phone (708) 534-1712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070011814 | IL | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Services, Inc | Current | Accepting new patients | |
| Medical Services, Inc | Current | Accepting new patients |
Locations
11040 N State Road 77
Hayward, WI 54843
Phone (715) 934-4244
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Tamarack Health Hayward Medical Center
- Critical Access Hospital
- Hayward, WI
- NPI 1912992827
-
dba Clinic Services of Hayward Area Memorial Hospital
- Rural Health Clinic/Center
- Hayward, WI
- NPI 1386316537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1003046251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3403 W OAKHILL DR",
"city": "CRETE",
"state": "IL",
"postal_code": "604171965",
"telephone_number": "708-534-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 197TH PL",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604117539",
"telephone_number": "708-755-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "NANCY",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-22",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IL",
"license": "070011814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.