Organization Active NPI

Physical Fundamentals, PLLC

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1699620054
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL FUNDAMENTALS, PLLC
Practice address
9004 S Leavitt St
Chicago, IL 60643-6438
Phone
(773) 490-9829
NPI assigned
Mar 2, 2026
Last updated
Mar 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Authorized official

Name
Lily Shen Elizabeth
Title
Physical Therapist
Phone
(773) 490-9829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

9004 S Leavitt St
Chicago, IL 60643-6438

Mailing address

9004 S Leavitt St
Chicago, IL 60643-6438
Phone (773) 490-9829

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1699620054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9004 S LEAVITT ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606436438",
            "telephone_number": "773-490-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9004 S LEAVITT ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606436438",
            "telephone_number": "773-490-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL FUNDAMENTALS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "ELIZABETH",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "SHEN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "773-490-9829"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.