Ellen Humphrey, P.T.
Individual provider Active NPI Physical Therapist · Lake Bluff, IL
NPI 1114256997 · NPPES record last updated Feb 14, 2018
Key facts
- NPI
- 1114256997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 101 Waukegan Rd Ste 1100
Lake Bluff, IL 60044-3012 - Phone
- (847) 247-2402
- Fax
- (847) 247-2405
- NPI assigned
- Dec 8, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161011001145 | IL | Practitioner - Physical Therapist in Private Practice | 0749578516 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
101 Waukegan Rd Ste 1100
Lake Bluff, IL 60044-3012
Mailing address
900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976
Other practice location 1
1200 N Westmoreland Rd
Lake Forest, IL 60045-1601
Phone (847) 535-7551
Other providers in Lake Bluff, IL
- Madison Hoover
- Lauren Howard
- Huggins Chiropractic and Acupunctureclinicltd
- Caryllon Cummings Huggins
- Teanna Huley
- Robert Iliff
- Illinois Bone and Joint Institue, LLC
- Illinois Bone and Joint Institute, LLC
- Illinois Bone and Joint Institute, LLC
- Illinois Bone and Joint Institute, LLC
All providers in Lake Bluff, IL · Physical 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 Feb 14, 2018. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.