Individual provider Active NPI

Donna Williams, BSPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1417083775
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070006372 Issued in IL
Practice address
1611 W Harrison St Ste 107
Chicago, IL 60612-4861
Phone
(877) 632-6637
Fax
(708) 409-5179
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05011936A IN
Physical Therapist 225100000X 070006372 IL Primary

Addresses

Primary practice location

1611 W Harrison St Ste 107
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St Ste 107
Chicago, IL 60612-4861
Phone (877) 632-6637

Other practice location 1

9200 Calumet Ave Ste 300
Munster, IN 46321-2885
Phone (877) 632-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100720000558 IL Practitioner - Physical Therapist in Private Practice 9830221266 Reassigns benefits to 2 organizations
I20160120002423 IN Practitioner - Physical Therapist in Private Practice 9830221266 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05011936AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Nov 1, 2015 Accepting new patients
Orthomidwest, PLLC Physical Therapist CurrentSince Jul 8, 2023 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Nov 1, 2015 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 107
Chicago, IL 60612
Phone (312) 432-2513

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Chicago, IL 60612
Phone (312) 243-4244

2011 York Rd
Ste 1500
Oak Brook, IL 60523
Phone (708) 492-5630

2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

9200 Calumet Ave
#300
Munster, IN 46321

9200 Calumet Ave
Ste 100
Munster, IN 46321
Phone (219) 595-0789

9200 Calumet Ave
Ste 300
Munster, IN 46321
Phone (708) 236-2737

Interoperability endpoints

  • Direct secure messaging: donna.williams.1@12576.direct.athenahealth.com

Organizations & group practices 5

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1417083775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 Calumet Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212885",
            "country_code": "US",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DONNA",
        "credential": "BSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011936A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070006372",
            "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 Jun 16, 2023; 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.