Movement Synergy Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MOVEMENT SYNERGY PHYSICAL THERAPY, LLC

Practice address

2000 N Racine Ave Ste 1000B
Chicago, IL 60614-7011

Phone

(630) 664-6298

Fax

(312) 253-1408

NPI assigned

Mar 19, 2019

Organization subpart

No

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

Authorized official

Name

Charles John Randa, PT, DPT, OCS, CSCSNPI 1184030025

Title

Owner

Phone

(630) 664-6298

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Charles J Randa, PT, DPT, CSCS

  • Physical Therapist
  • Chicago, IL
  • NPI 1184030025
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1922567809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1746 W HURON ST APT 3E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225631",
            "telephone_number": "630-664-6298",
            "fax_number": "312-253-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE STE 1000B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147011",
            "telephone_number": "630-664-6298",
            "fax_number": "312-253-1408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1746 W Huron St Apt 3E",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606225631",
            "country_code": "US",
            "telephone_number": "630-664-6298",
            "fax_number": "312-253-1408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOVEMENT SYNERGY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "RANDA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-664-6298",
        "authorized_official_credential": "PT, DPT, OCS, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Moutvic, DPT
• Gloria J Mouzon, M.D.
• Move Therapy and Wellness 1241 LLC
• Move Well Physical Therapy
• Movement Physical Therapy and Wellness PC
• Moving on Up Supportive Housing NFP
• Moving on Up Supportive Housing NFP
• Roman Movsisyan, MD
• Arun Kiran Movva
• Doaa Abdelrahman Mowafy, MD

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.