Individual provider Active NPI

Bethany Kalush

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1134878473
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070017254 Issued in IL
Practice address
5545 W Montrose Ave
Chicago, IL 60641-1331
Phone
(773) 282-6648
Fax
(773) 282-6965
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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 070017254 IL Primary

Addresses

Primary practice location

5545 W Montrose Ave
Chicago, IL 60641-1331

Mailing address

5545 W Montrose Ave
Chicago, IL 60641-1331
Phone (773) 282-6648

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL chptoffice@gmail.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220608000939 IL Practitioner - Physical Therapist in Private Practice 8729466461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Health and Physical Therapy Center SCGroup PAC ID 3870596455, 6 clinicians

Practice addresses (Care Compare)

5545 W Montrose Ave
Chicago, IL 60641-1331
Phone (773) 282-6648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Health and Physical Therapy Center SC CurrentSince Apr 4, 2022 Accepting new patients

Locations

5545 W Montrose Ave
Chicago, IL 60641
Phone (773) 282-6648

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1134878473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5545 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411331",
            "telephone_number": "773-282-6648",
            "fax_number": "773-282-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411331",
            "telephone_number": "773-282-6648",
            "fax_number": "773-282-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALUSH",
        "first_name": "BETHANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "chptoffice@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5545 W Montrose Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606411331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 23, 2022; 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.