NPIMap

Organization Active NPI

Wauconda Physical Therapy, Inc.

  • Orthopedic Physical Therapist
  • Wauconda, IL
National Provider Identifier
1982781316
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
WAUCONDA PHYSICAL THERAPY, INC.
Practice address
363 N Main St
Suite a
Wauconda, IL 60084-3036
Phone
(847) 487-0290
Fax
(847) 487-0492
NPI assigned
Nov 1, 2006
Last updated
Sep 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Authorized official

Name
Sharlene D Mecchi
Title
Practice Manager
Phone
(847) 487-0290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X IL Primary

Addresses

Primary practice location

363 N Main St
Suite a
Wauconda, IL 60084-3036

Mailing address

363 N Main St
Suite a
Wauconda, IL 60084-3036
Phone (847) 487-0290

Other names 1

  • wauconda wellness clinic, inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

363 N Main St
#A
Wauconda, IL 60084
Phone (847) 487-0290

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1982781316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 N MAIN ST",
            "address_2": "SUITE A",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600843036",
            "telephone_number": "847-487-0290",
            "fax_number": "847-487-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 N MAIN ST",
            "address_2": "SUITE A",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600843036",
            "telephone_number": "847-487-0290",
            "fax_number": "847-487-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUCONDA PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "MECCHI",
        "authorized_official_first_name": "SHARLENE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-487-0290"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "wauconda wellness clinic, inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wauconda, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.