Individual provider Active NPI

Avery Warner, DPT, ATC

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1669290748
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070028702 Issued in IL
Practice address
10 S Clinton St
Chicago, IL 60661-3400
Phone
(312) 234-9958
NPI assigned
Sep 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 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 070028702 IL Primary

Addresses

Primary practice location

10 S Clinton St
Chicago, IL 60661-3400

Mailing address

3130 N Lake Shore Dr Apt 1312
Chicago, IL 60657-4920
Phone (540) 840-5229

Other practice location 1

444 W Jackson Blvd
Chicago, IL 60606-6923
Phone (312) 407-0143

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022000763 IL Practitioner - Physical Therapist in Private Practice 2769914274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rci (WRS) LLCGroup PAC ID 5092624510, 325 clinicians

Practice addresses (Care Compare)

444 W Jackson Blvd
Lbby 1
Chicago, IL 60606-6951
Phone (312) 407-0143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070028702ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC. CurrentSince Sep 9, 2024 Accepting new patients
Rci (WRS), LLC. Physical Therapist Current Accepting new patients
Rci (WRS), LLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

444 W Jackson Blvd
Lbby 1
Chicago, IL 60606
Phone (312) 407-0143

10 S Clinton St
Chicago, IL 60661
Phone (312) 234-9958

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1727481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1669290748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 N LAKE SHORE DR APT 1312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574920",
            "telephone_number": "540-840-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S CLINTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613400",
            "telephone_number": "312-234-9958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 W Jackson Blvd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606066923",
            "country_code": "US",
            "telephone_number": "312-407-0143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNER",
        "first_name": "AVERY",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-28",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028702",
            "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 Sep 28, 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.