Individual provider Active NPI

Denise Anne Mudronja, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1750654455
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070018929 Issued in IL
Practice address
5333 N Sheridan Rd
Chicago, IL 60640-7371
Phone
(773) 997-2898
NPI assigned
Feb 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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 070018929 IL Primary

Addresses

Primary practice location

5333 N Sheridan Rd
Chicago, IL 60640-7371

Mailing address

5700 N Clark St
Unit 2
Chicago, IL 60660-4020
Phone (513) 479-9613

Other names 1

  • Ms. Denise Anne Gervais Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190826003858 IL Practitioner - Physical Therapist in Private Practice 6305174590 Reassigns benefits to 4 organizations
I20250611002521 OH Practitioner - Physical Therapist in Private Practice 6305174590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rex Therapeutics, LLCGroup PAC ID 7315342219, 21 clinicians

Practice addresses (Care Compare)

1390 S Crescent St
Gilman, IL 60938-6129
Phone (414) 721-8669

5790 Denlinger Rd
Dayton, OH 45426-2298
Phone (414) 721-8669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070018929ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jul 10, 2019 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Sep 3, 2024 Accepting new patients
Rex Therapeutics, LLC Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jul 10, 2019 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1390 S Crescent St
Gilman, IL 60938
Phone (414) 721-8669

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

7836 Frontage Rd
Skokie, IL 60077
Phone (414) 721-8669

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

5790 Denlinger Rd
Trotwood, OH 45426
Phone (414) 721-8669

Organizations & group practices 7

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": "1329004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1750654455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 N CLARK ST",
            "address_2": "UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604020",
            "telephone_number": "513-479-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407371",
            "telephone_number": "773-997-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDRONJA",
        "first_name": "DENISE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-12",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "GERVAIS",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 13, 2023; 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.