Individual provider Active NPI

Kaylee Barba

  • Physical Therapist
  • Gurnee, IL
National Provider Identifier
1043028624
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.028818 Issued in IL
Practice address
495 N Il Route 21 Ste 102
Gurnee, IL 60031-5919
Phone
(847) 599-9171
Fax
(847) 599-9124
NPI assigned
Dec 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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 070.028818 IL Primary

Addresses

Primary practice location

495 N Il Route 21 Ste 102
Gurnee, IL 60031-5919

Mailing address

495 N Il Route 21 Ste 102
Gurnee, IL 60031-5919
Phone (847) 599-9171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250317000476 IL Practitioner - Physical Therapist in Private Practice 6103348495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creative Rehab IncGroup PAC ID 3173879186, 6 clinicians

Practice addresses (Care Compare)

495 N Il Route 21
Suite 102
Gurnee, IL 60031-5919
Phone (847) 599-9171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.028818ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Rehab, Inc. CurrentSince Dec 16, 2024 Accepting new patients

Locations

495 N Riverside Dr
Ste 102
Gurnee, IL 60031
Phone (847) 599-9171

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.

NPI Registry JSON

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1043028624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N IL ROUTE 21 STE 102",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315919",
            "telephone_number": "847-599-9171",
            "fax_number": "847-599-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N IL ROUTE 21 STE 102",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315919",
            "telephone_number": "847-599-9171",
            "fax_number": "847-599-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBA",
        "first_name": "KAYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.028818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.