Individual provider Active NPI

Maureen O'Connell, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1063768489
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070019221 Issued in IL
Practice address
2727 N Clark St
Chicago, IL 60614-1551
Phone
(773) 969-4790
Fax
(773) 969-4811
NPI assigned
Aug 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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 070019221 IL Primary

Addresses

Primary practice location

2727 N Clark St
Chicago, IL 60614-1551

Mailing address

33900 Harper Ave
Suite 104
Clinton Township, MI 48035-4258
Phone (586) 416-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130705000089 IL Practitioner - Physical Therapist in Private Practice 0547400046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physio Partners PCGroup PAC ID 5890764401, 13 clinicians

Practice addresses (Care Compare)

2869 N Lincoln Ave
Chicago, IL 60657-4201
Phone (773) 665-9950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070019221ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Physical Therapy Partners of Il, PLLC Physical Therapist CurrentSince Sep 21, 2020 Accepting new patients

Locations

25 E Washington St
Ste 1310
Chicago, IL 60602
Phone (312) 855-1711

2869 N Lincoln Ave
Chicago, IL 60657
Phone (773) 665-9950

2700 Patriot Blvd
Ste 330
Glenview, IL 60026
Phone (847) 797-4543

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.

NPI Registry JSON

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1063768489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE",
            "address_2": "SUITE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-416-9100",
            "fax_number": "586-416-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141551",
            "telephone_number": "773-969-4790",
            "fax_number": "773-969-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019221",
            "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 Mar 21, 2017; 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.