Organization Active NPI

Jonathan Knipping Physical Therapy and Wellness LLC

  • Physical Therapy Clinic/Center
  • Park Ridge, IL
National Provider Identifier
1861009409
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
JONATHAN KNIPPING PHYSICAL THERAPY AND WELLNESS LLC
Practice address
640 Busse Hwy
Park Ridge, IL 60068-2502
Phone
(773) 934-4216
NPI assigned
Sep 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Jonathan Knipping, DPTNPI 1457603698
Title
Owner/Founder
Phone
(773) 934-4216

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

640 Busse Hwy
Park Ridge, IL 60068-2502

Mailing address

7620 N Osceola Ave
Niles, IL 60714-3127
Phone (773) 934-4216

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210109000017 IL Part B Supplier - Clinic/Group Practice 0547689788 Receives reassigned benefits from 1 practitioner
Practice locations: Niles, IL

National Provider Directory

National Provider Directory

Locations

640 Busse Hwy
Park Ridge, IL 60068
Phone (773) 934-4216

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1861009409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 N OSCEOLA AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143127",
            "telephone_number": "773-934-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 BUSSE HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682502",
            "telephone_number": "773-934-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN KNIPPING PHYSICAL THERAPY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "KNIPPING",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/FOUNDER",
        "authorized_official_telephone_number": "773-934-4216",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.