Active NPI
Aw Physical Rehab, LTD.
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1558493064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- AW PHYSICAL REHAB, LTD.
- Practice address
- 1069 W Argyle St
Chicago, IL 60640-3707 - Phone
- (773) 728-7022
- Fax
- (773) 989-9180
- NPI assigned
- Mar 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jack Pham
- Title
- Secretary
- Phone
- (773) 551-7022
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
1069 W Argyle St
Chicago, IL 60640-3707
Mailing address
1069 W Argyle St
Chicago, IL 60640-3707
Phone (773) 728-7022
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1558493064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1069 W ARGYLE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606403707",
"telephone_number": "773-728-7022",
"fax_number": "773-989-9180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1069 W ARGYLE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606403707",
"telephone_number": "773-728-7022",
"fax_number": "773-989-9180"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AW PHYSICAL REHAB, LTD.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PHAM",
"authorized_official_first_name": "JACK",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "773-551-7022",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.