Individual provider Active NPI

Katherine Wax, PT

  • Physical Therapist
  • Palos Heights, IL
National Provider Identifier
1710077557
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-014502 Issued in IL
Practice address
7225 W College Dr
Palos Heights, IL 60463-1101
Phone
(708) 361-5355
Fax
(708) 361-5399
NPI assigned
Oct 13, 2006
Last updated
Sep 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-014502 IL Primary

Addresses

Primary practice location

7225 W College Dr
Palos Heights, IL 60463-1101

Mailing address

1850 W Oakdale Ave
Chicago, IL 60657
Phone (815) 834-2400

Other identifiers 4

IdentifierTypeStateIssuer
1623066OtherILBCBS PROVIDER #
CJ4383OtherILR.R. MEDICARE GRP#
367885100OtherILUS DEPT OF LABOR PROV #
P00238078OtherILR.R. MEDICARE PIN #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816000339 IL Practitioner - Physical Therapist in Private Practice 8628008000 Reassigns benefits to 3 organizations

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
Rci (WRS) LLCGroup PAC ID 5092624510, 325 clinicians

Practice addresses (Care Compare)

3657 N Pine Grove Ave
Chicago, IL 60613-4503
Phone (773) 248-3401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-014502ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC. CurrentSince Dec 1, 2020 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Apr 25, 2018 Accepting new patients
Rci (WRS), LLC. Physical Therapist Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Apr 25, 2018 Accepting new patients
Rci (WRS), LLC CurrentSince Dec 1, 2020 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients

Locations

1835 Solutions Ctr
Chicago, IL 60677

3657 N Pine Grove Ave
Chicago, IL 60613
Phone (773) 248-3401

2500 Williamson County Pkwy
Ste B
Marion, IL 62959
Phone (618) 997-9497

826 W Touhy Ave
Park Ridge, IL 60068
Phone (847) 720-4165

Organizations & group practices 8

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1710077557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 W OAKDALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "815-834-2400",
            "fax_number": "815-834-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7225 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631101",
            "telephone_number": "708-361-5355",
            "fax_number": "708-361-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAX",
        "first_name": "KATHERINE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "1623066",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE GRP#",
            "identifier": "CJ4383",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR PROV #",
            "identifier": "367885100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE PIN #",
            "identifier": "P00238078",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.