Individual provider Active NPI

Dana S Weith, DPT

  • Physical Therapist
  • Homer Glen, IL
National Provider Identifier
1861622656
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.017186 Issued in IL
Practice address
14301 S Golden Oak Dr
Homer Glen, IL 60491-9696
Phone
(708) 645-7700
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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 070.017186 IL Primary

Addresses

Primary practice location

14301 S Golden Oak Dr
Homer Glen, IL 60491-9696

Mailing address

1117 W 17TH St
Chicago, IL 60608-2302
Phone (815) 353-2072

Other identifiers 1

IdentifierTypeStateIssuer
202421OtherMEDICARE GROUP ID-UNSPECIFIED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000566 IL Practitioner - Physical Therapist in Private Practice 2961558986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodlife Physical TherapyGroup PAC ID 6608924865, 10 clinicians

Practice addresses (Care Compare)

14753 Founders Xing
Homer Glen, IL 60491-6716
Phone (708) 645-7700

16517 106TH CT
Orland Park, IL 60467-4545
Phone (708) 966-4386

16517 S 106TH Court
Orland Park, IL 60467-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.017186ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Goodlife Physical Therapy Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
O'Connor Foundation Physical Therapist Current Accepting new patients

Locations

14753 Founders Xing
Homer Glen, IL 60491
Phone (708) 645-7700

16517 106th Ct
Orland Park, IL 60467
Phone (708) 966-4386

Organizations & group practices 2

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1861622656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 W 17TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082302",
            "telephone_number": "815-353-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14301 S GOLDEN OAK DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604919696",
            "telephone_number": "708-645-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITH",
        "first_name": "DANA",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.017186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID-UNSPECIFIED",
            "identifier": "202421",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.