Individual provider Active NPI

Nathan Deblauw, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1083228654
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070025121 Issued in IL
Practice address
1214 W Loyola Ave
Chicago, IL 60626-5102
Phone
(773) 274-1769
Fax
(773) 274-1937
NPI assigned
Sep 1, 2020
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 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 070025121 IL Primary

Addresses

Primary practice location

1214 W Loyola Ave
Chicago, IL 60626-5102

Mailing address

1214 W Loyola Ave
Chicago, IL 60626-5102
Phone (773) 274-1769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200929000041 IL Practitioner - Physical Therapist in Private Practice 7618396417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rci (WRS) LLCGroup PAC ID 5092624510, 325 clinicians
MMF Physical Therapy LLCGroup PAC ID 1052790508, 4 clinicians

Practice addresses (Care Compare)

1030 N Clark St
FL 6
Chicago, IL 60610-5467
Phone (312) 900-9595

1030 W N Ave
Suite 307
Chicago, IL 60642-2500
Phone (815) 243-2118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070025121ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), Inc. CurrentSince Sep 1, 2020 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Sep 1, 2020 Accepting new patients
Rci (WRS), LLC. Physical Therapist Current Accepting new patients
Rci (WRS), LLC CurrentSince Sep 1, 2020 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients

Locations

1030 N Clark St
Fl 6
Chicago, IL 60610
Phone (312) 900-9595

1214 W Loyola Ave
Chicago, IL 60626
Phone (773) 274-1769

1835 Solutions Ctr
Chicago, IL 60677

2930 S Michigan Ave
Ste 107
Chicago, IL 60616
Phone (312) 842-3919

2500 Williamson County Pkwy
Ste B
Marion, IL 62959
Phone (618) 997-9497

1804 Centre Point Cir
Ste 102
Naperville, IL 60563
Phone (630) 955-1940

9000 W College Pkwy
Palos Hills, IL 60465
Phone (618) 529-3201

826 W Touhy Ave
Park Ridge, IL 60068
Phone (847) 720-4165

Organizations & group practices 7

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": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1083228654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 W LOYOLA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606265102",
            "telephone_number": "773-274-1769",
            "fax_number": "773-274-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 W LOYOLA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606265102",
            "telephone_number": "773-274-1769",
            "fax_number": "773-274-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBLAUW",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070025121",
            "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 Sep 1, 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.