Individual provider Active NPI

Jenna Chavka

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1053711283
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070020924 Issued in IL
Practice address
4412 S Pulaski Rd
Chicago, IL 60632
Phone
(773) 847-3123
Fax
(773) 847-3778
NPI assigned
Aug 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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 070020924 IL Primary

Addresses

Primary practice location

4412 S Pulaski Rd
Chicago, IL 60632

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150213000653 IL Practitioner - Physical Therapist in Private Practice 5597080523 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

407 N Lagrange Rd
Lagrange Park, IL 60526-5623
Phone (708) 482-9320

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

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince May 18, 2020 Accepting new patients
Orland Park Integrated Health,LTD. Physical Therapist CurrentSince Jul 24, 2019 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist CurrentSince Mar 28, 2015 Accepting new patients
Athletico LTD Physical Therapist CurrentSince May 18, 2020 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Mar 28, 2015 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4412 S Pulaski Rd
Chicago, IL 60632
Phone (773) 847-3123

6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440

43 Bankview Dr
Frankfort, IL 60423
Phone (815) 469-6676

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

300 S State St
Marengo, IL 60152
Phone (815) 568-4550

9441 W 144th Pl
Ste 200
Orland Park, IL 60462
Phone (708) 403-2727

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

426 E 162nd St
South Holland, IL 60473
Phone (708) 333-0677

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

Organizations & group practices 5

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": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1053711283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-847-3123",
            "fax_number": "773-847-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVKA",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070020924",
            "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 Jun 25, 2018; 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.