Active NPI
Emerge Physical Therapy & Wellness PLLC
- Physical Therapist
- Chicago, IL
National Provider Identifier
1679105142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- EMERGE PHYSICAL THERAPY & WELLNESS PLLC
- Practice address
- 1962 N Bissell St Unit 1
Chicago, IL 60614-5015 - Phone
- (847) 975-3616
- NPI assigned
- Feb 12, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nicole F Wodka, DPT
- Title
- Manager
- Phone
- (847) 975-3616
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
1962 N Bissell St Unit 1
Chicago, IL 60614-5015
Mailing address
1330 N Dearborn St Apt 1601
Chicago, IL 60610-2080
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nicolewodka@emergeptw.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200411000182 | IL | Part B Supplier - Clinic/Group Practice | 4587093646 |
Receives reassigned benefits from 6 practitioners Practice locations: Chicago, IL |
National Provider Directory
National Provider DirectoryLocations
1962 N Bissell St
Ste 1
Chicago, IL 60614
Phone (312) 598-9991
1962 N Bissell St
Chicago, IL 60614
Practitioners & affiliated clinicians
Practitioners 6
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": "1581465600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1581465600000",
"number": "1679105142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 N DEARBORN ST APT 1601",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606102080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1962 N BISSELL ST UNIT 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606145015",
"telephone_number": "847-975-3616"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMERGE PHYSICAL THERAPY & WELLNESS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-12",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A",
"authorized_official_last_name": "WODKA",
"authorized_official_first_name": "NICOLE",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "847-975-3616",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nicolewodka@emergeptw.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1962 N Bissell St Unit 1",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606145015",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chicago, IL
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- Grace Chioma Emenogu, MD
- Oluwasegun Paul Emenogu, MD
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- Emerge Mental Health & College Counseling, LLC
- Emerge Psychology Group LLC
- Emergency Care Physician Services
- Emergency Care Physician Services HP, LTD.
- Emergency Dentist of Chicago PLLC
- Emergency Department Associates, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.