NPIMap

Organization Active NPI

Telos Therapy, LLC

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1306114699
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070013614 Issued in IL
Legal business name
TELOS THERAPY, LLC
Practice address
651 W Washington Blvd Ste 305
Chicago, IL 60661
Phone
(312) 880-9355
Fax
(312) 470-6550
NPI assigned
Dec 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Stefany A Sarelas, PTNPI 1164464467
Title
Owner/Physical Therapist
Phone
(312) 404-1548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 070013614 IL Primary

Addresses

Primary practice location

651 W Washington Blvd Ste 305
Chicago, IL 60661

Mailing address

651 W Washington Blvd Ste 305
Chicago, IL 60661-2137
Phone (312) 404-1548

Other practice location 1

7246 4th Ave S
St Petersburg, FL 33707-1232
Phone (312) 404-1548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120503000374 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1658533989 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL
O20240611002638 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1658533989 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

651 W Washington Blvd
Chicago, IL 60661

651 W Washington Blvd
Ste 305
Chicago, IL 60661
Phone (312) 404-1548

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1306114699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 W WASHINGTON BLVD STE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612137",
            "telephone_number": "312-404-1548",
            "fax_number": "312-470-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W WASHINGTON BLVD STE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60661",
            "telephone_number": "312-880-9355",
            "fax_number": "312-470-6550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7246 4th Ave S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337071232",
            "country_code": "US",
            "telephone_number": "312-404-1548",
            "fax_number": "312-470-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TELOS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SARELAS",
        "authorized_official_first_name": "STEFANY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "312-404-1548",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013614",
            "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 Nov 13, 2024; 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.