NPIMap

Organization Active NPI

Physio PR, PLLC

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1154900553
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSIO PR, PLLC
Practice address
900 W Margate Ter Apt 1C
Chicago, IL 60640-3824
Phone
(773) 556-8569
NPI assigned
Apr 5, 2021
Last updated
Apr 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
Elusegun Olopo, PT, DPTNPI 1518412741
Title
Owner
Phone
(773) 556-8569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

900 W Margate Ter Apt 1C
Chicago, IL 60640-3824

Mailing address

900 W Margate Ter Apt 1C
Chicago, IL 60640-3824
Phone (773) 556-8569

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1154900553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W MARGATE TER APT 1C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403824",
            "telephone_number": "773-556-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MARGATE TER APT 1C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403824",
            "telephone_number": "773-556-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO PR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "OLOPO",
        "authorized_official_first_name": "ELUSEGUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-556-8569",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.