Individual provider Active NPI

Greg Mierzwa

  • Physical Therapist
  • Chicago Ridge, IL
National Provider Identifier
1689030199
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070018409 Issued in IL
Practice address
10300 Southwest Hwy
Chicago Ridge, IL 60415-1426
Phone
(708) 425-1100
NPI assigned
Jan 13, 2016
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05010519A IN
Physical Therapist 225100000X 070018409 IL Primary

Addresses

Primary practice location

10300 Southwest Hwy
Chicago Ridge, IL 60415-1426

Mailing address

4615 N Beacon St Apt 1S
Chicago, IL 60640-7012
Phone (312) 343-3868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210616001460 IL Practitioner - Physical Therapist in Private Practice 9436559234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vital Care Wound Solutions CoGroup PAC ID 8022523463, 7 clinicians

Practice addresses (Care Compare)

1701 E Woodfield Rd
Suite 810
Schaumburg, IL 60173-5211
Phone (844) 484-9910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05010519AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Global Wound Care Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Vital Care Wound Solutions Co CurrentSince Dec 1, 2025 Accepting new patients

Locations

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

4001 W Devon Ave
Ste 300
Chicago, IL 60646
Phone (312) 448-7701

1701 E Woodfield Rd
Ste 745
Schaumburg, IL 60173

1701 E Woodfield Rd
Ste 810
Schaumburg, IL 60173
Phone (773) 341-6516

1821 Walden Office Sq
Ste 400
Schaumburg, IL 60173
Phone (323) 488-4863

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.

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1689030199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 N BEACON ST APT 1S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407012",
            "telephone_number": "312-343-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SOUTHWEST HWY",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151426",
            "telephone_number": "708-425-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIERZWA",
        "first_name": "GREG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010519A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.