Individual provider Active NPI

Kara Dwyer, DPT

  • Physical Therapist
  • Hanover Park, IL
National Provider Identifier
1710547377
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.024705 Issued in IL
Practice address
1744 E Lake St
Hanover Park, IL 60133-4810
Phone
(630) 246-4063
Fax
(630) 246-4195
NPI assigned
Jun 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 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 14628 WI
Physical Therapist 225100000X 070.024705 IL Primary

Addresses

Primary practice location

1744 E Lake St
Hanover Park, IL 60133-4810

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other practice location 1

411 N Randall Rd Ste F
Lake IN The Hills, IL 60156-6335
Phone (847) 854-9754 ext. 26265

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831002020 WA Practitioner - Physical Therapist in Private Practice 0648698746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10207 19TH Ave SE
Everett, WA 98208-4257
Phone (425) 337-3166

1332 Colby Ave
Everett, WA 98201-1618
Phone (425) 470-4040

2707 171St PL NE
Suite 101
Marysville, WA 98271-4740
Phone (360) 386-7401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.024705ILMDPhysical Therapist
14628WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Aug 9, 2021 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Aug 9, 2021 Accepting new patients
TJ Corporation I LLC PastSince May 1, 2022 Accepting new patients

Locations

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

Interoperability endpoints

  • Direct secure messaging: kara.dwyer.p9@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1710547377",
    "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": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 E LAKE ST",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601334810",
            "telephone_number": "630-246-4063",
            "fax_number": "630-246-4195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 N Randall Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Lake IN The Hills",
            "state": "IL",
            "postal_code": "601566335",
            "country_code": "US",
            "telephone_number": "847-854-9754 x26265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DWYER",
        "first_name": "KARA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14628",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.024705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.