Individual provider Active NPI

Dagan Rienks, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1659209054
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.039805 Issued in IL
Practice address
3168 N Broadway St
Chicago, IL 60657-4509
Phone
(312) 586-7977
NPI assigned
May 13, 2026
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 070.039805 IL Primary

Addresses

Primary practice location

3168 N Broadway St
Chicago, IL 60657-4509

Mailing address

3168 N Broadway St
Chicago, IL 60657-4509
Phone (312) 586-7977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603000255 IL Practitioner - Physical Therapist in Private Practice 8224509062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revolution PTWL LLCGroup PAC ID 7719115617, 42 clinicians

Practice addresses (Care Compare)

845 N Michigan Ave
Suite 973W
Chicago, IL 60611-2218
Phone (312) 878-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.039805ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution PTWL LLC Physical Therapist CurrentSince May 11, 2026 Accepting new patients

Locations

3168 N Broadway St
Chicago, IL 60657
Phone (312) 586-7977

845 N Michigan Ave
Ste 973W
Chicago, IL 60611
Phone (312) 651-6255

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1778630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1659209054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3168 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574509",
            "telephone_number": "312-586-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3168 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574509",
            "telephone_number": "312-586-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIENKS",
        "first_name": "DAGAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-13",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.039805",
            "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 May 13, 2026; 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.