Individual provider Active NPI

Lainey Havertape, PT, DPT

  • Physical Therapist
  • Shorewood, IL
National Provider Identifier
1083900583
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-020303 Issued in IL
Practice address
102 W Jefferson St
Shorewood, IL 60404-9502
Phone
(815) 215-7375
Fax
(630) 355-6216
NPI assigned
Jun 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11771-24 WI
Physical Therapist 225100000X 070-020303 IL Primary
Physical Therapist 225100000X 1177124 WI
Physical Therapist 225100000X 05010306A IN

Addresses

Primary practice location

102 W Jefferson St
Shorewood, IL 60404-9502

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lhavertape312707@dulyhealthandcare.direct-ci.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150327001949 IL Practitioner - Physical Therapist in Private Practice 2961659818 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-020303ILMDPhysical Therapist
05010306AINMDPhysical Therapist
11771-24WIMDPhysical Therapist
1177124WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Nov 17, 2025 Accepting new patients
Joint Care Physical Therapy Physical Therapist Current Accepting new patients
Midwest Rehabilitation Group Inc Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Dupage Medical Group LTD Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients
Advanced Rehabilitation Clinics, Inc Physical Therapist Past Accepting new patients

Locations

9735 Southwest Hwy
Oak Lawn, IL 60453
Phone (708) 424-7920

1325 N Meacham Rd
Schaumburg, IL 60173
Phone (630) 790-1700

102 W Jefferson St
Shorewood, IL 60404
Phone (815) 215-7375

Organizations & group practices 5

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1083900583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W JEFFERSON ST",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604049502",
            "telephone_number": "815-215-7375",
            "fax_number": "630-355-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERTAPE",
        "first_name": "LAINEY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11771-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-020303",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1177124",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010306A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lhavertape312707@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "102 W Jefferson St",
            "city": "Shorewood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604049502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.