Individual provider Active NPI

Odessa Diocares

  • Physical Therapist
  • Orland Park, IL
National Provider Identifier
1285021402
Registry record updated Apr 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070019553 Issued in IL
Practice address
16170 Kingsport Rd
Orland Park, IL 60467-5602
Phone
(708) 326-1550
NPI assigned
Apr 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2015

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 070019553 IL Primary

Addresses

Primary practice location

16170 Kingsport Rd
Orland Park, IL 60467-5602

Mailing address

16170 Kingsport Rd
Orland Park, IL 60467-5602
Phone (708) 326-1550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210914000317 IL Practitioner - Physical Therapist in Private Practice 0446656698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rex Therapeutics, LLC Physical Therapist CurrentSince Apr 3, 2025 Accepting new patients
Quality Therapy & Consultation, Inc. Physical Therapist Past Accepting new patients

Locations

1390 S Crescent St
Gilman, IL 60938
Phone (414) 721-8669

7836 Frontage Rd
Skokie, IL 60077
Phone (414) 721-8669

Organizations & group practices 2

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": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430006400000",
    "number": "1285021402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16170 KINGSPORT RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675602",
            "telephone_number": "708-326-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16170 KINGSPORT RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675602",
            "telephone_number": "708-326-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIOCARES",
        "first_name": "ODESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-26",
        "last_updated": "2015-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.