Active NPI
Ryan Zachary Wilson, PT, DPT
- Physical Therapist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-026470
- Practice address
- 2900 W Peterson Ave
Chicago, IL 60659-3818 - Phone
- (773) 596-5484
- Fax
- (773) 862-8578
- NPI assigned
- Oct 14, 2020
- Last updated
- Apr 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-026470 | IL | Primary |
| Orthopedic Physical Therapist | 2251X0800X | 13054 | CT | |
| Orthopedic Physical Therapist | 2251X0800X | 40QA01961200 | NJ | |
| Orthopedic Physical Therapist | 2251X0800X | 046507 | NY |
Addresses
Primary practice location
2900 W Peterson Ave
Chicago, IL 60659-3818
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2900 W Peterson Ave
Chicago, IL 60659-3804
Phone (773) 596-5484
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-026470 | IL | MD | Physical Therapist |
| 40QA01961200 | NJ | MD | Orthopedic Physical Therapist |
| 046507 | NY | MD | Orthopedic Physical Therapist |
| 13054 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
Locations
2900 W Peterson Ave
Chicago, IL 60659
Phone (773) 596-5484
280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088
Interoperability endpoints
- ryan.wilson.p9@direct.athleticoltd.nextgenshare.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Athletico Physical Therapy
- Clinic/Center
- Lafayette, IN
- NPI 1053044867
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1679171342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 YORK RD STE 300",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231925",
"telephone_number": "630-575-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 W PETERSON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606593818",
"telephone_number": "773-596-5484",
"fax_number": "773-862-8578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "RYAN",
"middle_name": "ZACHARY",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-14",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-026470",
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CT",
"license": "13054",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NJ",
"license": "40QA01961200",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NY",
"license": "046507",
"primary": false
}
],
"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 Apr 27, 2022; 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.