Robert Martin Waddell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

10201 S Cicero Ave
Oak Lawn, IL 60453-4098

Phone

(708) 658-2770

NPI assigned

Nov 9, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: rwaddell273088@direct.myadvocateaurora.org

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.

• Core Sport and Physical Therapy Downers Grove PLLC

  • Physical Therapist
  • Downers Grove, IL
  • NPI 1316818354
  NPD Authorized official
• Waddell Sports Rehab LLC

  • Sports Physical Therapist
  • Evergreen Park, IL
  • NPI 1972377273
  NPD Authorized official
• Core Sport & Physical Therapy PLLC

  • Physical Therapist
  • Evergreen Park, IL
  • NPI 1376375394
  NPD

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1184380792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 S TRUMBULL AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534098",
            "telephone_number": "708-658-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "ROBERT",
        "middle_name": "MARTIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-09",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwaddell273088@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10201 S Cicero Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604534098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10201 S Cicero Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604534098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandra Ann Voss, MS, CPNP
• Damir Vukomanovic, MD
• Caresse Lee Vuong
• Carol Ann Vysocky, PTA
• Kristi Marie Waddell, RN, APRN, BC
• Bridget Nora Wagner, PA-C
• Christopher Michael Wagner, MD
• Lindsey Allen Wagner, DPT
• Alanna Wahl
• Laquette Wair

• Physical Therapist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.