Individual provider Active NPI

Milan Krstovic, PT

  • Sports Physical Therapist
  • Chicago, IL
National Provider Identifier
1902472772
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
070.025799 Issued in IL
Practice address
1659 W Hubbard St
Chicago, IL 60622-6352
Phone
(312) 489-8579
NPI assigned
Jun 2, 2021
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.025799 IL
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X 070.025799 IL Primary

Addresses

Primary practice location

1659 W Hubbard St
Chicago, IL 60622-6352

Mailing address

3022 N Oakley Ave
Chicago, IL 60618-8317
Phone (732) 320-3097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013001544 IL Practitioner - Physical Therapist in Private Practice 5395105324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
FPT Lincoln Park LLCGroup PAC ID 9830636026, 2 clinicians

Practice addresses (Care Compare)

1963 N Sheffield Ave
Suite 1
Chicago, IL 60614-9150
Phone (732) 320-3097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.025799ILMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
FPT Lincoln Park LLC Physical Therapist CurrentSince Jul 26, 2024 Accepting new patients
Restore Proper Movement Physichalterapy LLC Current Accepting new patients

Locations

1963 N Sheffield Ave
Ste 1
Chicago, IL 60614
Phone (732) 320-3097

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, 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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1902472772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 N OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606188317",
            "telephone_number": "732-320-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 W HUBBARD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606226352",
            "telephone_number": "312-489-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRSTOVIC",
        "first_name": "MILAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025799",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "IL",
            "license": "070.025799",
            "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 Aug 24, 2023; 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.