Individual provider Active NPI

Denise Toombs, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1811397904
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.020896 Issued in IL
Practice address
4850 S Lake Park Ave Apt 911
Chicago, IL 60615-2047
Phone
(773) 456-7142
NPI assigned
Aug 26, 2014
Last updated
Apr 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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 070.020896 IL Primary

Addresses

Primary practice location

4850 S Lake Park Ave Apt 911
Chicago, IL 60615-2047

Mailing address

4850 S Lake Park Ave
Chicago, IL 60615-2130
Phone (773) 456-7142

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220408002000 IL Practitioner - Physical Therapist in Private Practice 7113313677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.020896ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Holistic Healthcare Services, Inc. CurrentSince Nov 26, 2021 Accepting new patients

Locations

1436 W Randolph St
Chicago, IL 60607
Phone (630) 310-2235

9020 S Stony Island Ave
Chicago, IL 60617
Phone (630) 310-2235

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1811397904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 S LAKE PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152130",
            "telephone_number": "773-456-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 S LAKE PARK AVE APT 911",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152047",
            "telephone_number": "773-456-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOMBS",
        "first_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020896",
            "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 12, 2017; 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.