Individual provider Active NPI

Poonam Bhargava

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1740494707
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070012354 Issued in IL
Practice address
5693 S Archer Ave
Chicago, IL 60638-1655
Phone
(773) 284-0888
Fax
(773) 284-0880
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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 070012354 IL Primary

Addresses

Primary practice location

5693 S Archer Ave
Chicago, IL 60638-1655

Mailing address

5693 S Archer Ave
Chicago, IL 60638-1655
Phone (773) 284-0888

Other identifiers 1

IdentifierTypeStateIssuer
1633794OtherILBCBS OF ILLINOIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070012354ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Rehabilitation Services Inc Physical Therapist Past Accepting new patients
Andersonville Physical Therapy, SC Physical Therapist PastSince Aug 1, 2001 Accepting new patients

Organizations & group practices 2

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1740494707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5693 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381655",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5693 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381655",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHARGAVA",
        "first_name": "POONAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "1633794",
            "state": "IL"
        }
    ],
    "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 Jul 21, 2009; 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.