Individual provider Active NPI

Sheila Dognidon Burgos

  • Physical Therapist
  • Glenview, IL
National Provider Identifier
1609042548
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-009797 Issued in IL
Practice address
3703 W Lake Ave
Suite200
Glenview, IL 60026-5823
Phone
(847) 998-1188
NPI assigned
Apr 30, 2008
Last updated
Aug 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-009797 IL Primary

Addresses

Primary practice location

3703 W Lake Ave
Suite200
Glenview, IL 60026-5823

Mailing address

15520 Natalie Dr
Oak Forest, IL 60452-3218
Phone (708) 415-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletic and Therapeutic Institute of Naperville, LLCGroup PAC ID 8325014020, shared by 8 NPIs, 251 clinicians

Practice addresses (Care Compare)

4555 211TH St
Matteson, IL 60443-2357
Phone (708) 283-0021

800 Des Plaines Ave
Forest Park, IL 60130-2927
Phone (708) 366-2442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-009797ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1609042548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15520 NATALIE DR",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523218",
            "telephone_number": "708-415-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 W LAKE AVE",
            "address_2": "SUITE200",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265823",
            "telephone_number": "847-998-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "SHEILA",
        "middle_name": "DOGNIDON",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-009797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.