Individual provider Active NPI

Norman J Mecwan, PT

  • Physical Therapist
  • Woodstock, IL
National Provider Identifier
1114398930
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-021476 Issued in IL
Practice address
2000 Lake Ave
Woodstock, IL 60098-7401
Phone
(815) 337-7100
Fax
(815) 337-4793
NPI assigned
Oct 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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 070-021476 IL Primary

Addresses

Primary practice location

2000 Lake Ave
Woodstock, IL 60098-7401

Mailing address

2000 Lake Ave
Woodstock, IL 60098-7401
Phone (815) 337-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330000730 IL Practitioner - Physical Therapist in Private Practice 9537466909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

2000 Lake Ave
Woodstock, IL 60098-7401
Phone (815) 337-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-021476ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Mar 7, 2016 Accepting new patients
Mercy Health System Corporation CurrentSince Mar 7, 2016 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

3922 Mercy Dr
McHenry, IL 60050
Phone (815) 344-4499

2000 Lake Ave
Woodstock, IL 60098
Phone (815) 337-4116

Interoperability endpoints

  • Direct secure messaging: nmecwan40756@direct.mhemail.org

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": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1114398930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987401",
            "telephone_number": "815-337-7100",
            "fax_number": "815-337-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987401",
            "telephone_number": "815-337-7100",
            "fax_number": "815-337-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECWAN",
        "first_name": "NORMAN",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-021476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.