Individual provider Active NPI

Zachery Tomanovich, PT,DPT

  • Orthopedic Physical Therapist
  • Westmont, IL
National Provider Identifier
1801376074
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
070.023820 Issued in IL
Practice address
350 E Ogden Ave Ste 200
Westmont, IL 60559-1289
Phone
(630) 908-7430
Fax
(630) 908-7458
NPI assigned
Aug 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 070.023820 IL Primary

Addresses

Primary practice location

350 E Ogden Ave Ste 200
Westmont, IL 60559-1289

Mailing address

16622 W 159TH St Ste 503
Lockport, IL 60441-8015
Phone (815) 838-5070

Other practice location 1

6901 S Madison St
Burr Ridge, IL 60527-5595
Phone (630) 590-5409

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181002001461 IL Practitioner - Physical Therapist in Private Practice 3476804469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Northwestern University Feinberg Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 W755 Butterfield Rd
Suite 103
Oakbrook Terrace, IL 60181-4524
Phone (630) 267-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.023820ILMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synaptyx Physical Medicine PLLC CurrentSince May 1, 2022 Accepting new patients

Locations

120 E Ogden Ave
Hinsdale, IL 60521
Phone (630) 267-5433

17W755 Butterfield Rd
Ste 103
Oakbrook Terrace, IL 60181
Phone (630) 267-5433

Organizations & group practices 1

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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1801376074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16622 W 159TH ST STE 503",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418015",
            "telephone_number": "815-838-5070",
            "fax_number": "815-838-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E OGDEN AVE STE 200",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591289",
            "telephone_number": "630-908-7430",
            "fax_number": "630-908-7458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6901 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "605275595",
            "country_code": "US",
            "telephone_number": "630-590-5409",
            "fax_number": "630-590-5783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMANOVICH",
        "first_name": "ZACHERY",
        "name_prefix": "Mr.",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070.023820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.