Individual provider Active NPI

Angelo Gregory Vargas, PT, DPT, OCS

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1376059014
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.023202 Issued in IL
Practice address
4801 W Peterson Ave Ste 606
Chicago, IL 60646-5728
Phone
(800) 974-4378
Fax
(630) 515-1536
NPI assigned
Dec 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X
Physical Therapist 225100000X 070.023202 IL Primary

Addresses

Primary practice location

4801 W Peterson Ave Ste 606
Chicago, IL 60646-5728

Mailing address

24014 W Renwick Rd Unit 206
Plainfield, IL 60544-8711
Phone (800) 974-4378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211122003010 IL Practitioner - Physical Therapist in Private Practice 2163811605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

5929 N Cicero Ave
Chicago, IL 60646-5701
Phone (800) 974-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.023202ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DPT Holdings PLLC Physical Therapist CurrentSince Nov 24, 2023 Accepting new patients

Locations

4801 W Peterson Ave
Ste 606
Chicago, IL 60646
Phone (773) 777-9100

5929 N Cicero Ave
Chicago, IL 60646
Phone (773) 283-8420

24014 W Renwick Rd
Ste 206
Plainfield, IL 60544

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1376059014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD UNIT 206",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448711",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE STE 606",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465728",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "ANGELO",
        "middle_name": "GREGORY",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.023202",
            "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 28, 2023; 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.