Individual provider Active NPI

Steve Hanley, DPT

  • Physical Therapist
  • Springfield, IL
National Provider Identifier
1184919698
Registry record updated Aug 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070018702 Issued in IL
Practice address
3148 W Iles Ave
Springfield, IL 62704-7447
Phone
(217) 891-7654
NPI assigned
Jun 13, 2011
Last updated
Aug 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2022

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 070018702 IL Primary

Addresses

Primary practice location

3148 W Iles Ave
Springfield, IL 62704-7447

Mailing address

228 Maggie Dr
Springfield, IL 62711-6362
Phone (217) 891-7654

Other identifiers 1

IdentifierTypeStateIssuer
P00992367OtherILMCRR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110913000628 IL Practitioner - Physical Therapist in Private Practice 1355512856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Break Free Physical Therapy PLLCGroup PAC ID 2466837661, 2 clinicians

Practice addresses (Care Compare)

3148 W Iles Ave
Springfield, IL 62704-7447
Phone (217) 891-7654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070018702ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jun 10, 2020 Accepting new patients
Break Free Physical Therapy PLLC Physical Therapist CurrentSince Jan 30, 2023 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jun 10, 2020 Accepting new patients

Locations

6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547

16139 Weber Rd
Crest Hill, IL 60403
Phone (815) 836-3403

1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440

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

300 S State St
Marengo, IL 60152
Phone (815) 568-4550

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

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

3148 W Iles Ave
Springfield, IL 62704
Phone (217) 891-7654

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

Organizations & group practices 3

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659830400000",
    "number": "1184919698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 MAGGIE DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116362",
            "telephone_number": "217-891-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3148 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047447",
            "telephone_number": "217-891-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "STEVE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2022-08-07",
        "certification_date": "2022-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P00992367",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2022; 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.