Individual provider Active NPI

Justin Andrew Samaniego Arcilla, PT, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1063262236
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.028108 Issued in IL
Practice address
4445 W Irving Park Rd Ste 300
Chicago, IL 60641-2808
Phone
(630) 933-1500
Fax
(630) 933-1550
NPI assigned
Mar 22, 2024
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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 070.028108 IL Primary

Addresses

Primary practice location

4445 W Irving Park Rd Ste 300
Chicago, IL 60641-2808

Mailing address

4445 W Irving Park Rd Ste 300
Chicago, IL 60641-2808
Phone (630) 933-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925003433 IL Practitioner - Physical Therapist in Private Practice 4385149749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4445 W Irving Park Rd
Chicago, IL 60641-2808
Phone (844) 344-6663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.028108ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 15, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 15, 2025 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

4445 W Irving Park Rd
Chicago, IL 60641
Phone (844) 344-6663

4445 W Irving Park Rd
Ste 300
Chicago, IL 60641
Phone (312) 695-8106

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1063262236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 W IRVING PARK RD STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412808",
            "telephone_number": "630-933-1500",
            "fax_number": "630-933-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 W IRVING PARK RD STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412808",
            "telephone_number": "630-933-1500",
            "fax_number": "630-933-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCILLA",
        "first_name": "JUSTIN ANDREW",
        "middle_name": "SAMANIEGO",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-22",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.028108",
            "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 Jan 5, 2026; 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.