Samantha B Cooper, OT
Individual provider Active NPI Occupational Therapist · Bannockburn, IL
NPI 1043825441 · NPPES record last updated Sep 11, 2020
Key facts
- NPI
- 1043825441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056-013779 (IL)
- Practice address
- 2211 Waukegan Rd
Bannockburn, IL 60015-1570 - Phone
- (847) 267-8600
- Fax
- (847) 267-9520
- NPI assigned
- Sep 11, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Athletico LTD
Practice addresses (Care Compare)
2211 Waukegan Rd
Bannockburn, IL 60015-1570
Phone (847) 267-8600
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200930002375 | IL | Practitioner - Occupational Therapist in Private Practice | 7911326558 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056-013779 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Current |
Accepting new patients | |
| Athletico LTD | Occupational Therapist | Current |
Accepting new patients |
Locations
2211 Waukegan Rd
Bannockburn, IL 60015
Phone (847) 267-8600
6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547
1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440
280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219
300 S State St
Marengo, IL 60152
Phone (815) 568-4550
722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088
600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056-013779 | IL | Yes |
Addresses
Primary practice location
2211 Waukegan Rd
Bannockburn, IL 60015-1570
Mailing address
600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200
Other providers in Bannockburn, IL
- Sara Chowdhury
- Clinical Connections
- Cognitive Balance Psychology PLLC
- Jennifer Cohen
- Arnold Cohn
- Megan Crawford
- Elizabeth M. Croley
- Peter Cui
- David Jeremy Davidson
- Amanda L. Deboy
All providers in Bannockburn, IL · Occupational Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.