Maxicare Physical Therapy & Wellness – Physical Therapist, NPI 1063963908
Physical Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Maxicare Physical Therapy & Wellness
605 Barrington Ave
East Dundee, IL 601181400
Phone: (779) 800-6698
Fax: (847) 515-4149
Type: Location
2632, Hearthstone Drive, Lakewood Crossings, Hampshire, Kane County, Illinois, 60140, United States
HAMPSHIRE, IL 601409024
Phone: (847) 505-6032
Type: Mailing
350 E CONGRESS PKWY STE A
CRYSTAL LAKE, IL 600146284
Phone: (847) 669-0286
Type: Location
2152 RANDALL RD
CARPENTERSVILLE, IL 601103345
Phone: (779) 800-6698
Fax: (847) 515-4149
Type: Mailing
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: 2016-12-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-06-30 (343 days ago).
Enrollment records
1
Earliest due date
2025-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20161230000979 | O | Physical/Occupational Therapy Group In Private Practice | IL | 2025-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60118)
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