Individual provider Active NPI

Caroline M Sobon, PT

  • Physical Therapist
  • Carol Stream, IL
National Provider Identifier
1003085119
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070003876 Issued in IL
Practice address
501 Thornhill Dr
Carol Stream, IL 60188-2793
Phone
(630) 653-1918
Fax
(630) 653-1928
NPI assigned
Feb 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070003876 IL Primary

Addresses

Primary practice location

501 Thornhill Dr
Carol Stream, IL 60188-2793

Mailing address

205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216
Phone (312) 640-0329

Other identifiers 5

IdentifierTypeStateIssuer
1619908OtherILBCBS IL GROUP NUMBER
1623066OtherILBCBS PROVIDER #
367885100OtherILU. S. DEPT OF LABOR
202542OtherILMEDICARE GROUP #
200852OtherILMEDICARE GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070003876ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Occusport Services Inc. Physical Therapist Past Accepting new patients
Accelerated Rehabilitation Centers LTD Physical Therapist Past Accepting new patients
Michael Reilly M.D. Holistic & Family Practice Medicine LTD Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1003085119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 THORNHILL DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882793",
            "telephone_number": "630-653-1918",
            "fax_number": "630-653-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBON",
        "first_name": "CAROLINE",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070003876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL GROUP NUMBER",
            "identifier": "1619908",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "1623066",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U. S. DEPT OF LABOR",
            "identifier": "367885100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "202542",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "200852",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.