Organization Active NPI

Meredy Parker Physical Therapy, LLC

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1992142442
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070009700 Issued in IL
Legal business name
MEREDY PARKER PHYSICAL THERAPY, LLC
Practice address
3717 N Ravenswood Ave
Suite 213
Chicago, IL 60613-3880
Phone
(773) 368-6176
NPI assigned
May 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Authorized official

Name
Dr. Meredy A Parker, PT, DPTNPI 1144354598
Title
Manager/Physical Therapist
Phone
(773) 368-6176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 070009700 IL Primary

Addresses

Primary practice location

3717 N Ravenswood Ave
Suite 213
Chicago, IL 60613-3880

Mailing address

1450 W Hutchinson St
Chicago, IL 60613-1312
Phone (773) 368-6176

Other identifiers 1

IdentifierTypeStateIssuer
IL3239OtherILMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190708000107 IL Part B Supplier - Clinic/Group Practice 1557602968 Receives reassigned benefits from 5 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

4721 N Clark St
Ste 1S
Chicago, IL 60640
Phone (773) 770-3682

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369267200000",
    "number": "1992142442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 W HUTCHINSON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131312",
            "telephone_number": "773-368-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 N RAVENSWOOD AVE",
            "address_2": "SUITE 213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133880",
            "telephone_number": "773-368-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEREDY PARKER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-23",
        "last_updated": "2013-05-23",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "MEREDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "773-368-6176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070009700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL3239",
            "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 May 23, 2013; 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.