Individual provider Active NPI

Jared Gibb, PT

  • Physical Therapist
  • Melrose Park, IL
National Provider Identifier
1003826207
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-014535 Issued in IL
Practice address
1440 W North Ave
Suite 202
Melrose Park, IL 60160-1422
Phone
(708) 865-8600
Fax
(708) 865-8661
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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 070-014535 IL Primary

Addresses

Primary practice location

1440 W North Ave
Suite 202
Melrose Park, IL 60160-1422

Mailing address

1000 E State Pkwy
Suite E
Schaumburg, IL 60173-4569
Phone (630) 285-8007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000502 IL Practitioner - Physical Therapist in Private Practice 3678583614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

546 N Rand Rd
Lake Zurich, IL 60047-3103
Phone (847) 438-6624

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-014535ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Nov 16, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Nov 16, 2018 Accepting new patients
Fox Valley Pain Center Service Corporation Past Accepting new patients
American Home Visiting Physicians Past Accepting new patients
Fahey Medical Center S.C. Past Accepting new patients
Midwest Physical Therapy Ctr PastSince Oct 1, 2009 Accepting new patients
Midwest Physical Therapy Ctr Past Accepting new patients

Locations

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

546 N Rand Rd
Lake Zurich, IL 60047
Phone (847) 438-6624

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

Organizations & group practices 7

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1003826207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E STATE PKWY",
            "address_2": "SUITE E",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734569",
            "telephone_number": "630-285-8007",
            "fax_number": "630-285-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 W NORTH AVE",
            "address_2": "SUITE 202",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601422",
            "telephone_number": "708-865-8600",
            "fax_number": "708-865-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBB",
        "first_name": "JARED",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.