Brad Scott Wolter, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.007821 Issued in IL

Practice address

173 N Harvey Ave
Oak Park, IL 60302-2622

Phone

(773) 213-8418

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Bradford Scott Wolter Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1245453737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 N HARVEY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022622",
            "telephone_number": "773-213-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 N HARVEY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022622",
            "telephone_number": "773-213-8418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1119 Hayes Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603021105",
            "country_code": "US",
            "telephone_number": "708-358-1231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLTER",
        "first_name": "BRAD",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "070007821",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.007821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRADFORD",
            "last_name": "WOLTER",
            "middle_name": "SCOTT",
            "prefix": "MR.",
            "credential": "PHYSICAL THERAPIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Andrew Wojda, LCSW
• Wolff Clinical Group PLLC
• Kara E Wolff, PHD
• Elizabeth Marie Wollensak, D.O.
• Seth Drummond Wollwage, L.C.S.W.
• Michele M Wolter, OTRL
• Ka Ngan Wong, OTR/L
• Michelle Gloria Wong
• Sabina Nicole Wong, MD
• Wood Counseling Center, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.