NPIMap

Organization Active NPI

PT Wellness

  • Pediatric Physical Therapist
  • Chicago, IL
National Provider Identifier
1952482515
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
070010529 Issued in IL
Legal business name
PT WELLNESS
Practice address
1315 N Bosworth
Chicago, IL 60622
Phone
(773) 203-1314
Fax
(773) 395-2215
NPI assigned
Oct 18, 2006
Last updated
Jul 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Ms. Sara Brin Karp, MAST OF PHYS THERAPY
Title
President
Phone
(773) 203-1314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251P0200X 070010529 IL Primary

Addresses

Primary practice location

1315 N Bosworth
Chicago, IL 60622

Mailing address

1315 N Bosworth
Chicago, IL 60622
Phone (773) 203-1314

Other identifiers 1

IdentifierTypeStateIssuer
01635329OtherILBCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1952482515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 N BOSWORTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "773-203-1314",
            "fax_number": "773-395-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 N BOSWORTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "773-203-1314",
            "fax_number": "773-395-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "KARP",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "BRIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-203-1314",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MAST OF PHYS THERAPY"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": "070010529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01635329",
            "state": "IL"
        }
    ],
    "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 Jul 23, 2008; 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.