Active NPI
Nicholas J Petronovich, DPT
- Physical Therapist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070024780
- Practice address
- 259 E Erie St Ste 13-205
Chicago, IL 60611-2987 - Phone
- (312) 695-8143
- Fax
- (312) 695-4075
- NPI assigned
- Sep 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070024780 | IL | Primary |
Addresses
Primary practice location
259 E Erie St Ste 13-205
Chicago, IL 60611-2987
Mailing address
259 E Erie St Ste 13-205
Chicago, IL 60611-2987
Phone (312) 695-8143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
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
Practice addresses (Care Compare)
259 E Erie St
13TH Floor
Chicago, IL 60611-3926
Phone (312) 472-6036
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070024780 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Orthopaedics at Rush, LLC | Current | Accepting new patients | |
| Orthomidwest, PLLC | Current | Accepting new patients | |
| Orthomidwest, PLLC | Physical Therapist | Current | Accepting new patients |
| Midwest Orthopaedics at Rush LLC | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Central Dupage Physician Group | Past | Accepting new patients |
Locations
770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060
Dept 5777
Carol Stream, IL 60122
1611 W Harrison St
Ste 107
Chicago, IL 60612
Phone (312) 432-2513
259 E Erie St
Fl 13
Chicago, IL 60611
1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244
259 E Erie St
Ste 13205
Chicago, IL 60611
1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577
18016 Wolf Rd
Orland Park, IL 60467
Phone (708) 364-9700
25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600
Organizations & group practices 7
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.
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- NPI 1811942451
-
- Durable Medical Equipment & Medical Supplies
- Orland Park, IL
- NPI 1134871908
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
- Durable Medical Equipment & Medical Supplies
- Buffalo Grove, IL
- NPI 1043180839
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1497304604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E ERIE ST STE 13-205",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112987",
"telephone_number": "312-695-8143",
"fax_number": "312-695-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 E ERIE ST STE 13-205",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112987",
"telephone_number": "312-695-8143",
"fax_number": "312-695-4075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRONOVICH",
"first_name": "NICHOLAS",
"middle_name": "J",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-10",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070024780",
"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 Jan 31, 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.