Individual provider Active NPI

Alan Munoz, PT, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1104635812
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070028827 Issued in IL
Practice address
6021 N Cicero Ave
Chicago, IL 60646-4301
Phone
(773) 628-7126
NPI assigned
Jan 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 070028827 IL Primary

Addresses

Primary practice location

6021 N Cicero Ave
Chicago, IL 60646-4301

Mailing address

1209 W Flournoy St
Chicago, IL 60607-3325
Phone (312) 505-2703

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250121002586 IL Practitioner - Physical Therapist in Private Practice 4789113721 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
Sports and Ortho PCGroup PAC ID 5698676740, 31 clinicians

Practice addresses (Care Compare)

6021 N Cicero Ave
Chicago, IL 60646-4301
Phone (773) 628-7126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070028827ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports and Ortho P.C CurrentSince Jan 3, 2025 Accepting new patients

Locations

412 W 31st St
Chicago, IL 60616
Phone (312) 225-3119

6021 N Cicero Ave
Chicago, IL 60646
Phone (773) 628-7126

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": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1104635812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W FLOURNOY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073325",
            "telephone_number": "312-505-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464301",
            "telephone_number": "773-628-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "ALAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028827",
            "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 7, 2025; 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.