Physical Wellness Lab, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL WELLNESS LAB, LLC

Practice address

1300 W Belmont Ave
Chicago, IL 60657-3200

Phone

(224) 765-1598

NPI assigned

Oct 27, 2021

Last updated

Nov 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kate Nugent Shean, PT

Title

Owner

Phone

(312) 925-5325

Specialties & licenses 3

Addresses

Other names 1

• Kathleen N Shean Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Shean, M.P.T.

  • Orthopedic Physical Therapist
  • Glenview, IL
  • NPI 1801920103
  NPD

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636848000000",
    "number": "1427712389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 E LAKE AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252265",
            "telephone_number": "312-925-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "224-765-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL WELLNESS LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-14",
        "status": "A",
        "authorized_official_last_name": "SHEAN",
        "authorized_official_first_name": "KATE",
        "authorized_official_middle_name": "NUGENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-925-5325",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kathleen N Shean",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.