Individual provider Active NPI

Lycurgus Talaganis, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1295023380
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070018572 Issued in IL
Practice address
4746 N Cumberland Ave
Chicago, IL 60656-4239
Phone
(773) 417-8901
Fax
(773) 717-5607
NPI assigned
Jul 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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 070018572 IL Primary

Addresses

Primary practice location

4746 N Cumberland Ave
Chicago, IL 60656-4239

Mailing address

4746 N Cumberland Ave
Chicago, IL 60656-4239
Phone (773) 417-8901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110816000453 IL Practitioner - Physical Therapist in Private Practice 4486823036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physical Therapy, LLCGroup PAC ID 2466998398, 43 clinicians

Practice addresses (Care Compare)

4746 N Cumberland Ave
Chicago, IL 60656-4239
Phone (773) 417-8901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Apr 26, 2016 Accepting new patients
Ipt Management Services, Inc. Physical Therapist CurrentSince Mar 19, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Apr 26, 2016 Accepting new patients

Locations

4746 N Cumberland Ave
Chicago, IL 60656
Phone (773) 417-8901

1103 S State St
Ste 300
Chicago, IL 60605
Phone (312) 877-5101

6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547

1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

300 S State St
Marengo, IL 60152
Phone (815) 568-4550

8337 W Lawrence Ave
Norridge, IL 60706
Phone (708) 583-9000

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

Organizations & group practices 4

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1295023380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4746 N CUMBERLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564239",
            "telephone_number": "773-417-8901",
            "fax_number": "773-717-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4746 N CUMBERLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564239",
            "telephone_number": "773-417-8901",
            "fax_number": "773-717-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALAGANIS",
        "first_name": "LYCURGUS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 25, 2018; 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.