Active NPI
Jordan Dubow, DPT
- Physical Therapist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070024480
- Practice address
- 111 North Wabash Ave Suite 100
#3279
Chicago, IL 60602-1903 - Phone
- (847) 987-5854
- NPI assigned
- Aug 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070024480 | IL | Primary |
Addresses
Primary practice location
111 North Wabash Ave Suite 100
#3279
Chicago, IL 60602-1903
Mailing address
2740 N Pine Grove Ave Apt 15B
Chicago, IL 60614-6616
Phone (847) 987-5854
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3161 N Broadway St
Chicago, IL 60657-4508
Phone (847) 220-4268
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070024480 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jodi H Kirsch DC,LLC | Physical Therapist | Current | Accepting new patients |
| Lux Concierge Physical Therapy PLLC | Physical Therapist | Current | Accepting new patients |
| Wicker Park Spine and Stability, LLC | Past | Accepting new patients |
Locations
3161 N Broadway St
Chicago, IL 60657
Phone (847) 220-4268
212 N Carpenter St
Unit A1A2
Chicago, IL 60607
212 N Carpenter St
Chicago, IL 60607
Phone (312) 928-9282
111 N Wabash Ave
Ste 100
Chicago, IL 60602
Phone (312) 219-1597
Organizations & group practices 3
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.
-
- Physical Therapy Clinic/Center
- Chicago, IL
- NPI 1649930108
Physical Therapist
-
- Chiropractor
- Chicago, IL
- NPI 1184370538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655510400000",
"number": "1639726383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 N PINE GROVE AVE APT 15B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606146616",
"telephone_number": "847-987-5854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 NORTH WABASH AVE SUITE 100",
"address_2": "#3279",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021903",
"telephone_number": "847-987-5854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOW",
"first_name": "JORDAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-19",
"last_updated": "2022-06-18",
"certification_date": "2022-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070024480",
"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 Jun 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.