Active NPI
Jess Brown, PT
- Physical Therapist
- Buffalo Grove, IL
National Provider Identifier
1003971300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070015935
- Practice address
- 1156 W Lake Cook Rd
Buffalo Grove, IL 60089-1979 - Phone
- (847) 520-7264
- Fax
- (847) 520-7290
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT870705 | DC | |
| Physical Therapist | 225100000X | 070015935 | IL | Primary |
Addresses
Primary practice location
1156 W Lake Cook Rd
Buffalo Grove, IL 60089-1979
Mailing address
205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216
Phone (312) 640-0329
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 567700 | Other | IL | MEDICARE GROUP NUMBER |
| 568150 | Other | IL | MEDICARE GROUP NUMBER |
| 1619908 | Other | IL | BCBS IL 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT870705 | DC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accelerated Rehabilitation Centers LTD | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Westmont, IL
- NPI 1205875713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227657600000",
"number": "1003971300",
"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": "1156 W LAKE COOK RD",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600891979",
"telephone_number": "847-520-7264",
"fax_number": "847-520-7290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JESS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2008-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "PT870705",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070015935",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "567700",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "568150",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IL GROUP",
"identifier": "1619908",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.