Organization Active NPI

Lux Concierge Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Chicago, IL
National Provider Identifier
1649930108
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
LUX CONCIERGE PHYSICAL THERAPY PLLC
Practice address
3161 N Broadway St
Chicago, IL 60657-4508
Phone
(847) 220-4268
NPI assigned
Dec 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Jordan DubowNPI 1639726383
Title
Physical Therapist
Phone
(847) 987-8554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3161 N Broadway St
Chicago, IL 60657-4508

Mailing address

3161 N Broadway St
Chicago, IL 60657-4508
Phone (847) 987-5854

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220328002066 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8224423397 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

3161 N Broadway St
Chicago, IL 60657
Phone (847) 220-4268

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1649930108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574508",
            "telephone_number": "847-987-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574508",
            "telephone_number": "847-220-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUX CONCIERGE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-26",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "DUBOW",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "847-987-8554"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "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 Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.