Individual provider Active NPI

Brynn Weimer, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1063723799
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070018069 Issued in IL
Practice address
1920 W Winona St
Chicago, IL 60640-2609
Phone
(316) 393-2946
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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 070018069 IL Primary

Addresses

Primary practice location

1920 W Winona St
Chicago, IL 60640-2609

Mailing address

1920 W Winona St Apt 3
Chicago, IL 60640-2609
Phone (316) 393-2946

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000759 IL Practitioner - Physical Therapist in Private Practice 9032398763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorycare CorporationGroup PAC ID 3870785132, 11 clinicians
Mack Physical Therapy LLCGroup PAC ID 5991022246, 4 clinicians

Practice addresses (Care Compare)

1057 Chadwick CT
Aurora, IL 60502-9323
Phone (630) 800-2444

227 E Ontario St
Suite 201
Chicago, IL 60611-3223
Phone (773) 417-6689

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070018069ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mack Physical Therapy LLC Physical Therapist CurrentSince Oct 10, 2021 Accepting new patients
Memorycare Corporation CurrentSince Jul 1, 2020 Accepting new patients

Locations

227 E Ontario St
Ste 201
Chicago, IL 60611
Phone (312) 527-9201

Organizations & group practices 2

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1063723799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 W WINONA ST APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402609",
            "telephone_number": "316-393-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W WINONA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402609",
            "telephone_number": "316-393-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIMER",
        "first_name": "BRYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018069",
            "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 19, 2020; 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.