Michael Chan, DPT

Individual provider Active NPI Physical Therapist · Elmwood Park, IL

NPI 1629647870 · NPPES record last updated Jun 28, 2021

Key facts

NPI
1629647870
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.025853 (IL)
Practice address
7230 W North Ave Ste 212
Elmwood Park, IL 60707-4213
Phone
(708) 456-2322
NPI assigned
Jun 22, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 19

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rci (WRS) LLC (325 clinicians)

Practice addresses (Care Compare)

7230 W N Ave
Suite 212
Elmwood Park, IL 60707-4213
Phone (708) 456-2322

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210723000690 IL Practitioner - Physical Therapist in Private Practice 3779986021 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070.025853ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC. Physical Therapist Current Accepting new patients
Rci (WRS), LLC. Current
since Jul 1, 2021
Accepting new patients
Rci (WRS), LLC Current
since Jul 1, 2021
Accepting new patients

Locations

7230 W North Ave
Ste 212
Elmwood Park, IL 60707
Phone (708) 336-1964

9000 W College Pkwy
Palos Hills, IL 60465
Phone (618) 529-3201

826 W Touhy Ave
Park Ridge, IL 60068
Phone (847) 720-4165

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.025853 IL Yes

Addresses

Primary practice location

7230 W North Ave Ste 212
Elmwood Park, IL 60707-4213

Mailing address

108 Coventry CT
Naperville, IL 60565-2217
Phone (630) 649-8626

Other providers in Elmwood Park, IL

All providers in Elmwood Park, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.