NPIMap

Organization Active NPI

Real PT LLC

  • Physical Therapy Clinic/Center
  • Chicago, IL
National Provider Identifier
1760860621
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
REAL PT LLC
Practice address
1659 W Hubbard St
Chicago, IL 60622-6352
Phone
(312) 489-8579
NPI assigned
May 12, 2015
Last updated
Apr 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Adam Wolf, PTNPI 1952502627
Title
Member
Phone
(312) 420-9565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1659 W Hubbard St
Chicago, IL 60622-6352

Mailing address

1659 W Hubbard St
Chicago, IL 60622-6352
Phone (312) 489-8579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200501002337 IL Part B Supplier - Clinic/Group Practice 4789015983 Receives reassigned benefits from 8 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

1659 W Hubbard St
Chicago, IL 60622
Phone (312) 489-8579

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1760860621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 W HUBBARD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606226352",
            "telephone_number": "312-489-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 W HUBBARD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606226352",
            "telephone_number": "312-489-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "312-420-9565",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "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 Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.