NPIMap

Organization Active NPI

Prava PC

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1841003753
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRAVA PC
Practice address
1920 W Potomac Ave
Chicago, IL 60622-3149
Phone
(877) 472-2261
Fax
(877) 349-1138
NPI assigned
Jan 27, 2025
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Dr. Mark Shen, MDNPI 1508826405
Title
Owner
Phone
(877) 472-2261

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1920 W Potomac Ave
Chicago, IL 60622-3149

Mailing address

1920 W Potomac Ave
Chicago, IL 60622-3149
Phone (877) 472-2261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SC, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20250312001698 MN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931620432 Receives reassigned benefits from 3 practitioners
Practice locations: Maple Grove, MN
O20250324002220 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931620432 Receives reassigned benefits from 19 practitioners
Practice locations: Aiken, SC
O20250409000495 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931620432 Receives reassigned benefits from 50 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

128 S Tryon St
Ste 1920
Charlotte, NC 28202

Practitioners & affiliated clinicians

Practitioners 66

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.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1841003753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 W POTOMAC AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223149",
            "telephone_number": "877-472-2261",
            "fax_number": "877-349-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W POTOMAC AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223149",
            "telephone_number": "877-472-2261",
            "fax_number": "877-349-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAVA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "SHEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-472-2261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 9, 2025; 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.