Individual provider Active NPI

Evan Matthew Whaley, DPT

  • Physical Therapist
  • Westchester, IL
National Provider Identifier
1114421369
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.023534 Issued in IL
Practice address
2450 Wolf Rd Ste E
Westchester, IL 60154-5643
Phone
(708) 273-8410
NPI assigned
Mar 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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 070.023534 IL Primary

Addresses

Primary practice location

2450 Wolf Rd Ste E
Westchester, IL 60154-5643

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180406001854 IL Practitioner - Physical Therapist in Private Practice 0345503207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.023534ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopaedics at Rush LLC CurrentSince Apr 12, 2021 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Apr 12, 2021 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Feb 22, 2018 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Feb 22, 2018 Accepting new patients
Orthomidwest, PLLC Physical Therapist Current Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

3082 Caton Farm Rd
Joliet, IL 60435
Phone (630) 783-2001

2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577

2450 Wolf Rd
Ste F
Westchester, IL 60154
Phone (708) 236-2750

2450 Wolf Rd
Ste E
Westchester, IL 60154
Phone (708) 273-8410

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • Direct secure messaging: evan.whaley.1@12576.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1114421369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 WOLF RD STE E",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545643",
            "telephone_number": "708-273-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "EVAN",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.023534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westchester, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.