ENGRAM THERAPY AND WELLNESS CLINIC
NPI 1295404820
Physical Therapist in Chicago, IL

Active since September 08, 2021
2655 W PETERSON AVE, CHICAGO, IL 60659(630) 729-4344 Get Directions Write a Review

NPPES record last updated: April 1, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 22, 2021, Sep 8, 2021 (2 updates tracked since 2021).

About Engram Therapy And Wellness Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ENGRAM THERAPY AND WELLNESS CLINIC (NPI 1295404820) is a healthcare organization registered as a physical therapist in Chicago, Illinois and active in the NPI registry since September 2021. The organization lists Carla Mae R Haverland, Ceo, as its authorized official.

NPPES Registry Identity

NPI1295404820
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameENGRAM
Location Address2655 W PETERSON AVEChicago, IL 60659-4017
Mailing Address2655 W Peterson AveChicago, IL 60659-4017 · (630) 729-4344
Organization SubpartYes
Authorized OfficialCarla Mae R HaverlandCeo · (630) 729-4344
Enumeration DateSeptember 8, 2021
Last NPPES UpdateApril 1, 20222 updates tracked since enumeration
NPPES CertifiedApril 1, 2022
✔ NPI 1295404820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
Also ListedOccupational TherapistTaxonomy 225X00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
2655 W PETERSON AVE, Chicago, IL 60659

Other Names 1

Doing Business AsEngram Therapy And Wellness Clinic

Other Identifiers 1

Medicaid1184899072IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Engram Therapy And Wellness Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Engram Therapy And Wellness Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Physical Therapist in Private Practice
NPI 1184899072
2655 W PETERSON AVE
Chicago, IL 60659
(773) 942-6528
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1760293203
2165 S TONNE DR APT 122
Arlington Heights, IL 60005
(224) 518-9149
15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Engram's NPI number?

The NPI number for Engram is 1295404820. It was assigned to this organization in the NPPES registry on September 8, 2021. The provider is doing business as Engram Therapy And Wellness Clinic.

Where is Engram located?

Engram is located at 2655 W Peterson Ave, Chicago, IL 60659. The listed phone number is (630) 729-4344.

What is Engram's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Engram enrolled in Medicare?

Yes. Engram is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Engram?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Engram. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Engram was last updated on April 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.