Individual provider Active NPI

Lawrence John Wenzel, PT

  • Physical Therapist
  • McHenry, IL
National Provider Identifier
1265431704
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4306 W Crystal Lake Rd
McHenry, IL 60050-4249
Phone
(815) 385-7090
Fax
(815) 363-0401
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

4306 W Crystal Lake Rd
McHenry, IL 60050-4249

Mailing address

4306 W Crystal Lake Rd
McHenry, IL 60050-4249
Phone (815) 385-7090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040628000006 IL Practitioner - Physical Therapist in Private Practice 8224014568 Reassigns benefits to 1 organization
I20230503002862 WI Practitioner - Physical Therapist in Private Practice 8224014568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4306 W Crystal Lake Rd
Suite a
McHenry, IL 60050-4249
Phone (815) 385-7090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-006566ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Apr 10, 2023 Accepting new patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Apr 10, 2023 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265431704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 W CRYSTAL LAKE RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504249",
            "telephone_number": "815-385-7090",
            "fax_number": "815-363-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 W CRYSTAL LAKE RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504249",
            "telephone_number": "815-385-7090",
            "fax_number": "815-363-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "LAWRENCE",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.