Dean Papadopoulos, DPT
Individual provider Active NPI Physical Therapist · Fox Lake, IL
NPI 1194744995 · NPPES record last updated Jul 24, 2023
Key facts
- NPI
- 1194744995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 13522 (WI)
- Practice address
- 1294 S Route 12
Fox Lake, IL 60020-1950 - Phone
- (847) 973-9440
- Fax
- (847) 973-9442
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13522 | WI | MD | Cardiovascular Disease Physician |
| 070-014551 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paxxon Healthcare Services LLC | Physical Therapist | Current |
Accepting new patients |
| Paxxon Healthcare Services LLC | Physical Therapist | Current |
Accepting new patients |
| Greenfield Rehabilitation Agency, Inc. | Physical Therapist | Current |
Accepting new patients |
| Greenfield Rehabilitation Agency, Inc. | Physical Therapist | Current |
Accepting new patients |
| Global Care S.C. | Past |
Accepting new patients |
Locations
3360 Gateway Rd
Ste 100
Brookfield, WI 53045
Phone (262) 295-6289
1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-014551 | IL | |
| Physical Therapist | 225100000X | 13522 | WI | Yes |
Addresses
Primary practice location
1294 S Route 12
Fox Lake, IL 60020-1950
Mailing address
Greenfield Rehab Agency
3360 Gateway Rd. Suite 100
Brookfield, WI 53045
Phone (262) 923-7101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL6237020 | Other | IL | MEDICARE |
| IL6697018 | Other | IL | MEDICARE |
| 1619908 | Other | IL | BCBS IL GROUP |
| 568080 | Other | IL | MEDICARE GROUP NUMBER |
| 568150 | Other | IL | MEDICARE GROUP NUMBER |
| 567700 | Other | IL | MEDICARE GOUP NUMBER |
| IL6238020 | Other | IL | MEDICARE |
Other providers in Fox Lake, IL
- Jaye Nelson
- Northern Illinois Foot & Ankle Specialists, LTD
- Northwestern Lake Counseling
- Amanda C Otten
- Zoe Ozse
- Johnny Passarelli
- Ashish Patel
- Leticia Perez
- Pinto-Thomas, M.D., S.C.
- Michelle Renee Ponselle-Mays
All providers in Fox Lake, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.