Individual provider Active NPI

Shannon Nicole Possardt, DPT, NCS

  • Neurology Physical Therapist
  • Chicago, IL
National Provider Identifier
1255060968
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
070.027276 Issued in IL
Practice address
355 E Erie St
Chicago, IL 60611-3167
Phone
(312) 238-1000
NPI assigned
Jun 8, 2022
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X 070.027276 IL Primary

Addresses

Primary practice location

355 E Erie St
Chicago, IL 60611-3167

Mailing address

654 W Thomas St
Elmhurst, IL 60126-3027
Phone (630) 709-2331

Other names 1

  • Dr. Shannon Nicole O'Connor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729004648 IL Practitioner - Physical Therapist in Private Practice 0547707358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tryability LLCGroup PAC ID 9537499272, 12 clinicians

Practice addresses (Care Compare)

3050 Finley Rd
Suite 301
Downers Grove, IL 60515-1196
Phone (331) 775-2813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.027276ILMDNeurology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tryability LLC Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients

Locations

3050 Finley Rd
Ste 301
Downers Grove, IL 60515
Phone (331) 775-2813

3140 Finley Rd
Ste 400D
Downers Grove, IL 60515
Phone (331) 775-2813

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1255060968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 W THOMAS ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263027",
            "telephone_number": "630-709-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113167",
            "telephone_number": "312-238-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POSSARDT",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DPT, NCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "IL",
            "license": "070.027276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "O'CONNOR",
            "middle_name": "NICOLE",
            "prefix": "DR.",
            "credential": "DPT, NCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 11, 2024; 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.