Organization Active NPI

Activemed Physical Therapy and Wellness, LLC

  • Physical Therapist
  • Glenview, IL
National Provider Identifier
1801528500
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACTIVEMED PHYSICAL THERAPY AND WELLNESS, LLC
Practice address
1871 Waukegan Rd
Glenview, IL 60025-2158
Phone
(630) 414-9092
NPI assigned
Jun 30, 2022
Last updated
Jun 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Aneta Starowicz, MPTNPI 1346911682
Title
Physical Therapist
Phone
(630) 414-9092

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 Therapist 225100000X NU Primary

Addresses

Primary practice location

1871 Waukegan Rd
Glenview, IL 60025-2158

Mailing address

52 JF Kennedy Blvd
Elk Grove Village, IL 60007-3606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231222002399 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678923224 Receives reassigned benefits from 1 practitioner
Practice locations: Glenview, IL

National Provider Directory

National Provider Directory

Locations

1871 Waukegan Rd
Glenview, IL 60025
Phone (630) 414-9092

Practitioners & affiliated clinicians

Practitioners 1

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": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1801528500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 JF KENNEDY BLVD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252158",
            "telephone_number": "630-414-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVEMED PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "STAROWICZ",
        "authorized_official_first_name": "ANETA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "630-414-9092",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.