Individual provider Active NPI

David Andrew Johnson, P.T.

  • Physical Therapist
  • Highland Park, IL
National Provider Identifier
1154482008
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.017873 Issued in IL
Practice address
1770 1St St Ste 100
Highland Park, IL 60035-3210
Phone
(847) 432-4077
Fax
(847) 681-8940
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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 070.017873 IL Primary

Addresses

Primary practice location

1770 1St St Ste 100
Highland Park, IL 60035-3210

Mailing address

1770 1St St Ste 100
Highland Park, IL 60035-3210
Phone (847) 432-4077

Other identifiers 1

IdentifierTypeStateIssuer
L73851OtherILPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111104000668 IL Practitioner - Chiropractic 8123018421 Reassigns benefits to 1 organization
I20111230000448 IL Practitioner - Physical Therapist in Private Practice 8123018421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1770 1St St
Highland Park, IL 60035-3210
Phone (847) 432-4077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.017873ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Spinal & Sports Rehabilitation, LTD Physical Therapist CurrentSince Jan 22, 2023 Accepting new patients
North Shore Spinal & Sports Rehabilitation, LTD Physical Therapist CurrentSince Sep 1, 1992 Accepting new patients

Locations

1770 1st St
Ste 100
Highland Park, IL 60035
Phone (847) 432-4077

100 E Scranton Ave
Lake Bluff, IL 60044
Phone (847) 295-0920

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1154482008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 1ST ST STE 100",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353210",
            "telephone_number": "847-432-4077",
            "fax_number": "847-681-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 1ST ST STE 100",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353210",
            "telephone_number": "847-432-4077",
            "fax_number": "847-681-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.017873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "L73851",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.