Active NPI
Russell Koenig, MS
- Clinical Exercise Physiologist
- Chicago, IL
National Provider Identifier
1023445269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- Practice address
- 88 W Schiller St Apt 1601
Chicago, IL 60610-2041 - Phone
- (312) 878-8800
- Fax
- (312) 448-9978
- NPI assigned
- Oct 2, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | Primary |
Addresses
Primary practice location
88 W Schiller St Apt 1601
Chicago, IL 60610-2041
Mailing address
88 W. Schiller Street #1601
Chicago, IL 60610
Phone (312) 878-8800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revolution PTWL LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Chicago, IL
- NPI 1164766606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380672000000",
"number": "1023445269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 W. SCHILLER STREET #1601",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60610",
"telephone_number": "312-878-8800",
"fax_number": "312-448-9978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 W SCHILLER ST APT 1601",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606102041",
"telephone_number": "312-878-8800",
"fax_number": "312-448-9978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "RUSSELL",
"name_prefix": "Mr.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-02",
"last_updated": "2013-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.