Individual provider Active NPI

Brandi L Storck, PT

  • Physical Therapist
  • Plainfield, IL
National Provider Identifier
1124056205
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070013437 Issued in IL
Practice address
4714 Caton Farm Rd
Plainfield, IL 60586-8350
Phone
(815) 676-3950
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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 070013437 IL Primary

Addresses

Primary practice location

4714 Caton Farm Rd
Plainfield, IL 60586-8350

Mailing address

13430 Skyline Dr
Plainfield, IL 60585-1914
Phone (815) 676-3950

Other identifiers 3

IdentifierTypeStateIssuer
367885100OtherILUS DEPT OF LABOR
1619908OtherILBCBS IL GROUP NUMBER
1623066OtherILBCBS PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000636 IL Practitioner - Physical Therapist in Private Practice 7719908474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brady, P.C.Group PAC ID 2163508227, 14 clinicians

Practice addresses (Care Compare)

1337 Lily Cache LN
Bolingbrook, IL 60490-4600
Phone (630) 226-5110

4714 Caton Farm Rd
Plainfield, IL 60586-8350
Phone (815) 676-3950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brady, P.C. Physical Therapist CurrentSince Nov 22, 2010 Accepting new patients
Creative Therapy Resource, LLC Physical Therapist PastSince Jan 1, 2006 Accepting new patients
Midwest Rehabilitation Group Inc Physical Therapist PastSince Sep 1, 2021 Accepting new patients
Accelerated Rehabilitation Centers LTD Physical Therapist Past Accepting new patients
Occusport Services Inc. Physical Therapist Past Accepting new patients

Locations

1337 Lily Cache Ln
Bolingbrook, IL 60490
Phone (630) 226-5110

4714 Caton Farm Rd
Plainfield, IL 60586
Phone (815) 609-4988

12640 S Route 59
Unit 110
Plainfield, IL 60585
Phone (815) 676-3905

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1124056205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13430 SKYLINE DR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605851914",
            "telephone_number": "815-676-3950",
            "fax_number": "815-676-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4714 CATON FARM RD",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605868350",
            "telephone_number": "815-676-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORCK",
        "first_name": "BRANDI",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "367885100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL GROUP NUMBER",
            "identifier": "1619908",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1623066",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.