Revolution Physical Therapy Weight Loss

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

164006766 Issued in IL

Legal business name

REVOLUTION PHYSICAL THERAPY WEIGHT LOSS

Practice address

205 N. Wells St.
Chicago, IL 60606

Phone

(312) 878-8800

NPI assigned

May 5, 2016

Organization subpart

No

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

Authorized official

Name

Katrina Wyszomirski-Corn

Title

Manager of Office Operations

Phone

(312) 878-8800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1922454255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W WACKER DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061217",
            "telephone_number": "312-878-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N. WELLS ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60606",
            "telephone_number": "312-878-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION PHYSICAL THERAPY WEIGHT LOSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-05",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "WYSZOMIRSKI-CORN",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "MANAGER OF OFFICE OPERATIONS",
        "authorized_official_telephone_number": "312-878-8800"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "164006766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Chiropractic
• Revive Relationship Therapy Inc.
• Gadi Asher Revivo, D.O.
• Revolution Counseling and Wellness LLC
• Revolution Health Systems
• Revolution PTWL LLC
• Reweave Therapy PLLC
• Dorothy Rewinski, D.D.S.
• Kaitlyn Elizabeth Rewis, MD
• Rex Pharmaceuticals Inc

• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.