Individual provider Active NPI

Jessica M Gonzalez, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1427619063
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
151 N Michigan Ave Ste C47
Chicago, IL 60601-7974
Phone
(312) 379-0000
Fax
(312) 379-0001
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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 IL Primary

Addresses

Primary practice location

151 N Michigan Ave Ste C47
Chicago, IL 60601-7974

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190903001801 IL Practitioner - Physical Therapist in Private Practice 8325377294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revolution PTWL LLCGroup PAC ID 7719115617, 42 clinicians

Practice addresses (Care Compare)

845 N Michigan Ave
Suite 973W
Chicago, IL 60611-2218
Phone (312) 878-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Aug 15, 2019 Accepting new patients
Revolution PTWL LLC Physical Therapist CurrentSince Sep 15, 2021 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 15, 2019 Accepting new patients

Locations

845 N Michigan Ave
Ste 973W
Chicago, IL 60611
Phone (312) 651-6255

205 N Wells St
Chicago, IL 60606
Phone (312) 957-8882

3418 S Halsted St
Chicago, IL 60608
Phone (773) 337-7627

4851 N Milwaukee Ave
Chicago, IL 60630
Phone (773) 241-7350

3168 N Broadway St
Chicago, IL 60657
Phone (312) 586-7977

720 Roosevelt Rd
Glen Ellyn, IL 60137
Phone (630) 730-8456

2200 Waukegan Rd
Glenview, IL 60025
Phone (312) 475-1893

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

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

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

28 N Cass Ave
Westmont, IL 60559
Phone (630) 435-1800

Organizations & group practices 3

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1427619063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MICHIGAN AVE STE C47",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017974",
            "telephone_number": "312-379-0000",
            "fax_number": "312-379-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "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 25, 2019; 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.