Individual provider Active NPI

Clare E Kennedy, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1154551208
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070017245 Issued in IL
Practice address
2500 W 94TH St
Chicago, IL 60805-2818
Phone
(773) 233-9570
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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 070017245 IL Primary

Addresses

Primary practice location

2500 W 94TH St
Chicago, IL 60805-2818

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6250

Other practice location 1

2304 W 95th St
Chicago, IL 60643-1004
Phone (773) 233-9570

Other identifiers 1

IdentifierTypeStateIssuer
1633794OtherBCBS OF ILLINOIS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090909000672 IL Practitioner - Physical Therapist in Private Practice 8628123957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

2500 W 94TH St
Evergreen Park, IL 60805-2818
Phone (773) 233-9570

407 N Lagrange Rd
Lagrange Park, IL 60526-5623
Phone (708) 482-9320

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
070017245ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Dec 19, 2017 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 19, 2017 Accepting new patients
Chicago Rehabilitation Services Inc Physical Therapist PastSince Oct 1, 2003 Accepting new patients
The University of Chicago Medical Center Past Accepting new patients

Locations

2500 W 94th St
Evergreen Pk, IL 60805
Phone (773) 233-9570

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

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

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

Organizations & group practices 4

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1154551208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W 94TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "608052818",
            "telephone_number": "773-233-9570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2304 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606431004",
            "country_code": "US",
            "telephone_number": "773-233-9570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CLARE",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "1633794",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.