Individual provider Active NPI

Andrea Sabine Wieger, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1649514274
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070010468 Issued in IL
Practice address
651 W Washington Blvd Ste 305
Chicago, IL 60661-2137
Phone
(773) 216-4567
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 070010468 IL Primary

Addresses

Primary practice location

651 W Washington Blvd Ste 305
Chicago, IL 60661-2137

Mailing address

509 W Roscoe St
Apt BB
Chicago, IL 60657-3542
Phone (847) 256-2890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131210001431 IL Practitioner - Physical Therapist in Private Practice 7911134325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Telos Therapy LLCGroup PAC ID 1658533989, 3 clinicians

Practice addresses (Care Compare)

651 W Washington Blvd
Suite 305
Chicago, IL 60661-2137
Phone (312) 880-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Contingency Physical Therapy PLLC Physical Therapist CurrentSince Feb 4, 2024 Accepting new patients
Telos Therapy, LLC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients

Locations

651 W Washington Blvd
Chicago, IL 60661

651 W Washington Blvd
Ste 305
Chicago, IL 60661
Phone (312) 404-1548

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1649514274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 W ROSCOE ST",
            "address_2": "APT BB",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573542",
            "telephone_number": "847-256-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W WASHINGTON BLVD STE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612137",
            "telephone_number": "773-216-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGER",
        "first_name": "ANDREA",
        "middle_name": "SABINE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070010468",
            "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 Nov 13, 2024; 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.

Verify at the official NPI Registry.