Bertha Xitlaly Golem, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.014584 Issued in IL

Practice address

600 N McClurg CT
Ste A312
Chicago, IL 60611-3011

Phone

(312) 337-8840

Fax

(312) 337-9334

NPI assigned

Nov 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Bertha Xitlaly Rivera Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1598093841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MCCLURG CT",
            "address_2": "STE A312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113011",
            "telephone_number": "312-337-8840",
            "fax_number": "312-337-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MCCLURG CT",
            "address_2": "STE A312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113011",
            "telephone_number": "312-337-8840",
            "fax_number": "312-337-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLEM",
        "first_name": "BERTHA",
        "middle_name": "XITLALY",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-25",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014584",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.014584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERTHA",
            "last_name": "RIVERA",
            "middle_name": "XITLALY",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Goldsztejn, OTD
• Mohamad Goldust Jouybari
• Richard Goldwasser, PH D LCPC
• Nicole Goldwater, LCSW
• Janusz Edward Golec, MD
• Jennifer Leigh Golem, P.T.
• Katherine Sarah Golem, LSW
• Julie Golembiewski, PHARMD
• Shahin Golestani, PT
• Kristen L Goliak, PHARM.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 Oct 23, 2012; 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.