Individual provider Active NPI

Craig James Mawdsley, DPT, COMT, FAAOMPT

  • Physical Therapist
  • Western Springs, IL
National Provider Identifier
1003832387
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-013518 Issued in IL
Practice address
814 Hillgrove Ave
Western Springs, IL 60558-1439
Phone
(708) 505-3900
Fax
(708) 505-4647
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-013518 IL Primary

Addresses

Primary practice location

814 Hillgrove Ave
Western Springs, IL 60558-1439

Mailing address

814 Hillgrove Ave
Western Springs, IL 60558-1439
Phone (708) 505-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070117000413 IL Practitioner - Physical Therapist in Private Practice 0941201933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarity Physical Therapy and Wellness Center LLCGroup PAC ID 4082847041, 7 clinicians

Practice addresses (Care Compare)

814 Hillgrove Ave
Western Springs, IL 60558-1439
Phone (708) 505-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-013518ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Physical Therapy and Wellness Center, LLC Physical Therapist CurrentSince Mar 3, 2014 Accepting new patients
DX Physical Therapy & Rehabilitation, LTD. Past Accepting new patients
Achieve Orthopedic Rehabilitation Institute,Inc Physical Therapist PastSince Nov 26, 2002 Accepting new patients
Alpha Rehabilitation Medical Center LTD Past Accepting new patients

Locations

814 Hillgrove Ave
Western Springs, IL 60558
Phone (708) 505-3900

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1003832387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 HILLGROVE AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581439",
            "telephone_number": "708-505-3900",
            "fax_number": "708-505-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 HILLGROVE AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581439",
            "telephone_number": "708-505-3900",
            "fax_number": "708-505-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWDSLEY",
        "first_name": "CRAIG",
        "middle_name": "JAMES",
        "credential": "DPT, COMT, FAAOMPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-013518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.