Individual provider Active NPI

Kristin Walsh

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1770537409
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
11240 S Western Ave
Chicago, IL 60643-4116
Phone
(773) 779-1111
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 IL Primary

Addresses

Primary practice location

11240 S Western Ave
Chicago, IL 60643-4116

Mailing address

11240 S Western Ave
Chicago, IL 60643-4116
Phone (773) 779-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000710 IL Practitioner - Physical Therapist in Private Practice 3678517398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Back and Joint PLLCGroup PAC ID 3072926385, 4 clinicians

Practice addresses (Care Compare)

11540 183Rd PL
Suite SE
Orland Park, IL 60467-5431
Phone (708) 310-6733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070011960ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Back and Joint PLLC CurrentSince Jun 23, 2022 Accepting new patients
Vital Rehabilitation & Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

11540 183rd Pl
Ste Se
Orland Park, IL 60467
Phone (708) 310-6733

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770537409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434116",
            "telephone_number": "773-779-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434116",
            "telephone_number": "773-779-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "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 Jul 13, 2026; 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.