Individual provider Active NPI

Dhwani Shah

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1760841803
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.021969 Issued in IL
Practice address
1255 S State St Unit 6
Chicago, IL 60605-1928
Phone
(312) 880-0808
NPI assigned
Feb 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 070.021969 IL Primary
Physical Therapist 225100000X 25784 MD

Addresses

Primary practice location

1255 S State St Unit 6
Chicago, IL 60605-1928

Mailing address

570 Village Center Dr Ste 205
Burr Ridge, IL 60527-4526
Phone (309) 204-6706

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329002961 IL Practitioner - Physical Therapist in Private Practice 5890092241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physical Therapy PCGroup PAC ID 0446214845, 12 clinicians

Practice addresses (Care Compare)

1255 S State St
Suite 6
Chicago, IL 60605-1928
Phone 63092046706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25784MDMDMental Health Counselor
070.021969ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy PC Physical Therapist CurrentSince Jun 29, 2022 Accepting new patients
Premiere Anesthesia Group LLC PastSince Jul 1, 2016 Accepting new patients

Locations

570 Village Center Dr
Ste 205
Burr Ridge, IL 60527

1850 W Winchester Rd
Ste 223
Libertyville, IL 60048
Phone (847) 680-3020

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": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1760841803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 VILLAGE CENTER DR STE 205",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605274526",
            "telephone_number": "309-204-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 S STATE ST UNIT 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051928",
            "telephone_number": "312-880-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DHWANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.021969",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25784",
            "primary": false
        }
    ],
    "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 Sep 17, 2024; 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.