Amy Therese Clysdale, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.025949 Issued in IL

Practice address

5669 N Northwest Hwy
Chicago, IL 60646-6153

Phone

(773) 467-5669

Fax

(773) 631-2926

NPI assigned

Jul 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1508539768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 W DAKIN ST APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606130170",
            "telephone_number": "651-308-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466153",
            "telephone_number": "773-467-5669",
            "fax_number": "773-631-2926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 S Promontory Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606491002",
            "country_code": "US",
            "telephone_number": "773-363-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLYSDALE",
        "first_name": "AMY",
        "middle_name": "THERESE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-25",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kate Clucas, LPC
• Zebedee David Cluff, PA-C
• Jennifer Julia Clumpner, MD
• Bethany Ann Cluskey, M.D.
• Lauren Clutter, MA, CCC-SLP
• CMJ Medical Enterprises LTD
• CMP Professional Services
• Cnec Employee Benefits and Corporate Law, Inc.
• Cnutrition LLC
• Jeffrey Alan Coady, PSY.D.

• 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 Jul 27, 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.