Active NPI
Mary Buzzard, DPT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1720436652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070022620
- Practice address
- 220 W Huron St Ste 2004
Chicago, IL 60654-3951 - Phone
- (312) 643-1555
- Fax
- (312) 896-5993
- NPI assigned
- Jun 1, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070022620 | IL | Primary |
Addresses
Primary practice location
220 W Huron St Ste 2004
Chicago, IL 60654-3951
Mailing address
220 W Huron St Ste 2004
Chicago, IL 60654-3951
Phone (312) 643-1555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
220 W Huron St
Suite 2004
Chicago, IL 60654-3951
Phone (312) 643-1555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Physical Therapy Chicago LLC | Physical Therapist | Current | Accepting new patients |
Locations
220 W Huron St
Ste 2004
Chicago, IL 60654
Phone (312) 643-1555
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.
-
- Physical Therapist
- Chicago, IL
- NPI 1033638010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1720436652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 W HURON ST STE 2004",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606543951",
"telephone_number": "312-643-1555",
"fax_number": "312-896-5993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 W HURON ST STE 2004",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606543951",
"telephone_number": "312-643-1555",
"fax_number": "312-896-5993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUZZARD",
"first_name": "MARY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-01",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070022620",
"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 May 3, 2019; 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.