Individual provider Active NPI

Sewon Lee, DPT

  • Physical Therapist
  • Burtonsville, MD
National Provider Identifier
1104412139
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30487 Issued in MD
Practice address
15630 Old Columbia Pike Ste F
Burtonsville, MD 20866-1617
Phone
(240) 559-5270
NPI assigned
Dec 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-025543 IL
Physical Therapist 225100000X 30487 MD Primary

Addresses

Primary practice location

15630 Old Columbia Pike Ste F
Burtonsville, MD 20866-1617

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

526 E Jefferson St Ste 110
Rockford, IL 61107-4076
Phone (815) 997-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210105000671 IL Practitioner - Physical Therapist in Private Practice 4385057744 Reassigns benefits to 3 organizations
I20250820000503 DC Practitioner - Physical Therapist in Private Practice 4385057744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

15630 Old Columbia Pike
Suite F
Burtonsville, MD 20866-1617
Phone (240) 559-5270

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
30487MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist CurrentSince Aug 3, 2022 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Aug 3, 2022 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 25, 2025 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 25, 2025 Accepting new patients
Athletic & Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

1806 N Market St
Champaign, IL 61822
Phone (217) 356-4920

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

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

16819 Torrence Ave
Lansing, IL 60438
Phone (708) 394-5215

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

526 E Jefferson St
Ste 110
Rockford, IL 61107
Phone (815) 255-8102

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

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743

15630 Old Columbia Pike
Ste F
Burtonsville, MD 20866
Phone (240) 559-5270

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

Interoperability endpoints

  • Direct secure messaging: sewon.lee.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1104412139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15630 OLD COLUMBIA PIKE STE F",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661617",
            "telephone_number": "240-559-5270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "526 E Jefferson St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611074076",
            "country_code": "US",
            "telephone_number": "815-997-5500",
            "fax_number": "815-255-8102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SEWON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-025543",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.