Individual provider Active NPI

Dena Tadros, DPT

  • Physical Therapist
  • Tinley Park, IL
National Provider Identifier
1710028501
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014957 Issued in IL
Practice address
7545 W 159TH St
Tinley Park, IL 60477-9305
Phone
(708) 691-0321
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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 05010742A IN
Physical Therapist 225100000X 070014957 IL Primary

Addresses

Primary practice location

7545 W 159TH St
Tinley Park, IL 60477-9305

Mailing address

7545 W 159TH St
Tinley Park, IL 60477-9305
Phone (708) 691-0321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820000734 IL Practitioner - Physical Therapist in Private Practice 5698922094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theory Physical Therapy LLCGroup PAC ID 5092190934, 3 clinicians

Practice addresses (Care Compare)

7545 W 159TH St
Tinley Park, IL 60477-9305
Phone (708) 691-0321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theory Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients

Locations

7545 W 159th St
Tinley Park, IL 60477
Phone (708) 532-7711

Organizations & group practices 1

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1710028501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7545 W 159TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604779305",
            "telephone_number": "708-691-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7545 W 159TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604779305",
            "telephone_number": "708-691-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADROS",
        "first_name": "DENA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010742A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.