Individual provider Active NPI

Colleen L Wood, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1053629295
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-018071 Issued in IL
Practice address
1455 W Webster Ave # 4
Chicago, IL 60614
Phone
(773) 871-3100
Fax
(773) 871-7388
NPI assigned
Sep 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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 070-018071 IL Primary

Addresses

Primary practice location

1455 W Webster Ave # 4
Chicago, IL 60614

Mailing address

625 Enterprise Dr.
Oak Brook, IL 60523-8813
Phone (630) 575-6250

Other practice location 1

1953 N Clybourn Ave
Unit S
Chicago, IL 60614-4945
Phone (773) 871-3100

Other names 1

  • Colleen L Burke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-018071ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1053629295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR.",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 W WEBSTER AVE # 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-871-3100",
            "fax_number": "773-871-7388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1953 N Clybourn Ave",
            "address_2": "Unit S",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606144945",
            "country_code": "US",
            "telephone_number": "773-871-3100",
            "fax_number": "773-871-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "COLLEEN",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-018071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "BURKE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.