Individual provider Active NPI

Amanda Grace Wolff, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1942059332
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.028138 Issued in IL
Practice address
3420 N Lincoln Ave
Chicago, IL 60657-1195
Phone
(773) 360-7287
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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 070.028138 IL Primary

Addresses

Primary practice location

3420 N Lincoln Ave
Chicago, IL 60657-1195

Mailing address

411 W Fullerton Pkwy
Chicago, IL 60614-2870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.028138ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipt Management Services, Inc. Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients

Locations

3420 N Lincoln Ave
Chicago, IL 60657
Phone (773) 360-7287

1103 S State St
Ste 300
Chicago, IL 60605
Phone (312) 877-5101

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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1942059332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W FULLERTON PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571195",
            "telephone_number": "773-360-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "AMANDA",
        "middle_name": "GRACE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.028138",
            "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 May 16, 2024; 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.