Individual provider Active NPI

Leanne Reed, PT

  • Physical Therapist
  • Bannockburn, IL
National Provider Identifier
1164439030
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014262 Issued in IL
Practice address
2525 Waukegan Rd #255
Bannockburn, IL 60069
Phone
(847) 623-5450
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 070014262 IL Primary

Addresses

Primary practice location

2525 Waukegan Rd #255
Bannockburn, IL 60069

Mailing address

6547 N Avondale Ave Ste 1
Chicago, IL 60631-1983
Phone (773) 775-1622

Other identifiers 1

IdentifierTypeStateIssuer
070014262MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060921000144 IL Practitioner - Physical Therapist in Private Practice 3577559251 Reassigns benefits to 1 organization
I20200303002682 NC Practitioner - Physical Therapist in Private Practice 3577559251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2525 Waukegan Rd
Suite 255
Bannockburn, IL 60015-5502

2525 Waukegan Rd
Suite 255
Bannockburn, IL 60015-5514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070014262ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saylor Physical Therapy Cornelius LLC CurrentSince Dec 17, 2019 Accepting new patients
Wellness Club, LTD Physical Therapist CurrentSince Mar 1, 2021 Accepting new patients

Locations

2223 Lakeside Dr
Bannockburn, IL 60015
Phone (773) 983-3475

19460 Old Jetton Rd
Ste 202
Cornelius, NC 28031
Phone (704) 255-6879

Organizations & group practices 2

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164439030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6547 N AVONDALE AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311983",
            "telephone_number": "773-775-1622",
            "fax_number": "773-775-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 WAUKEGAN RD #255",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "60069",
            "telephone_number": "847-623-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "LEANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070014262",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bannockburn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.