Spencer Fang, PT, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

070024872 Issued in IL

Practice address

1824 Johns Dr
Glenview, IL 60025-1657

Phone

(847) 581-6300

NPI assigned

Dec 9, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2019

Medicare assignment

May accept Medicare assignment

Group practices

Sommo LLCGroup PAC ID 0446558803, 4 clinicians

Free Body Physical Therapy Professional CorporationGroup PAC ID 5698050169, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sommo LLC

  • Physical Therapy Clinic/Center
  • Glenview, IL
  • NPI 1639530371
  Medicare reassignment Care Compare group NPD
• Free Body Physical Therapy Professional Corporation

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1407398126
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1114564135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 JOHNS DR",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600251657",
            "telephone_number": "847-581-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 JOHNS DR",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600251657",
            "telephone_number": "847-581-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "SPENCER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "070024872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family and Child Roots & Wings, PLLC
• Family Dental Center
• Family Dental Practice
• Family Guidance Centers, Inc.
• Jonathan Hwa Fang, M.D.
• Leanne Farley, P.T.
• Rabiya Farooqui
• Marlon Kirkpatrick Farquharson X
• Fast Care Diagnostics LLC
• Lindsay Travelstead Fazio, PHD

• Physical Medicine & Rehabilitation Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.