MICHELE WYLDE (PT, ATC) – Physical Therapist, NPI 1962730416

MICHELE WYLDE (PT, ATC) is a healthcare provider. based in Waterman, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, ATC. They hold a License No. 070.014036 (IL). The NPI Number for MICHELE WYLDE (PT, ATC) is 1962730416

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
MICHELE WYLDE (PT, ATC)
NPI
1962730416
Phone
(815) 264-8600
Address
PO BOX 98
Enumeration Date
20 November 2009
Last Update Date
1 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8152648600
Graduation Year
2004 (22 years ago)
PAC ID
1759651185
Group Practice PAC ID
0941257760
Professional Enrollment ID
I20170718003041
Address ID
IL605564000WA320XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness85
Years active:16State licenses:2Digital endpointsOther names

5,028 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

Provider Addresses for MICHELE WYLDE (PT, ATC)

  • PO BOX 98

    WATERMAN, IL 605560098

    Phone: (815) 264-8600

    Fax: (331) 431-5462

    Type: Mailing

  • 320 W ADAMS ST

    WATERMAN, IL 605564000

    Phone: (815) 264-8600

    Fax: (331) 431-5462

    Type: Location

  • 125 North Cedar Street

    Waterman, IL 60556

    Phone: (815) 264-8600

    Fax: (815) 264-8600

    Type: Location

  • 125, North Cedar Street, Waterman, Clinton Township, DeKalb County, Illinois, 60556, United States

    WATERMAN, IL 60556

    Phone: (815) 264-8600

    Fax: (815) 264-8600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-07-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170718003041IPhysical Therapist In Private PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes93851$0
97140Therapy procedure using manual technique, each 15 minutes42546$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes16415$0
97161Evaluation for physical therapy, typically 20 minutes1613$0
View full utilization report →

Insurance plans in this area (ZIP 60556)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941257760View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Occupational Therapist In Private PracticeIL

Reviews

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Frequently asked questions

What NPI should I save for MICHELE WYLDE (PT, ATC)?
Save NPI 1962730416 if you need a stable reference for MICHELE WYLDE (PT, ATC).
Is MICHELE WYLDE (PT, ATC) currently active in the NPI registry?
CMS-published data lists MICHELE WYLDE (PT, ATC) as an active registrant.
Does MICHELE WYLDE (PT, ATC) list a primary specialty?
If you are matching referrals, note Physical Therapist for MICHELE WYLDE (PT, ATC). Clinical services aligned with this taxonomy classification.
What location metadata exists for MICHELE WYLDE (PT, ATC)?
The page summarizes Waterman, Illinois for MICHELE WYLDE (PT, ATC); expand the address list for detail.
What if Waterman, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.