Active NPI
Marley Coughlin, PT
- Physical Therapist
- Tinley Park, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.026131
- Practice address
- 17495 La Grange Rd
Tinley Park, IL 60487-7581 - Phone
- (630) 967-2000
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.026131 | IL | Primary |
Addresses
Primary practice location
17495 La Grange Rd
Tinley Park, IL 60487-7581
Mailing address
1860 Paysphere Cir
Chicago, IL 60674-3807
Phone (630) 469-9200
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mcoughlin231654@direct.edward.org | ||
| Direct Messaging Address | mcoughlin231654@dulyhealthandcare.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210913000444 | IL | Practitioner - Physical Therapist in Private Practice | 0547666810 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Saint Louis University School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2101 Waukegan Rd
Bannockburn, IL 60015-1836
3000 N Halsted St
Chicago, IL 60657-9269
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.07 of 100
- Quality
- 76.54
- Promoting interoperability
- 83
- Improvement activities
- 40
- Cost
- 74.52
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.026131 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Bone and Joint Institute, LLC | Current | Accepting new patients | |
| Illinois Bone and Joint Institute LLC | Current | Accepting new patients |
Locations
2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096
3000 N Halsted St
Ste 527
Chicago, IL 60657
Phone (773) 328-5930
2923 N California Ave
Ste 301
Chicago, IL 60618
Phone (773) 327-5639
5057 Paysphere Cir
Chicago, IL 60674
900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090
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.
-
- Orthopaedic Surgery Physician
- Bannockburn, IL
- NPI 1205922432
IL
-
- Orthopaedic Surgery Physician
- Arlington Heights, IL
- NPI 1962219568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1194493809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 PAYSPHERE CIR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606743807",
"telephone_number": "630-469-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17495 LA GRANGE RD",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604877581",
"telephone_number": "630-967-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUGHLIN",
"first_name": "MARLEY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.026131",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mcoughlin231654@direct.edward.org",
"affiliation": "N",
"address_1": "17495 La Grange Rd",
"city": "Tinley Park",
"state": "IL",
"country_code": "US",
"postal_code": "604877581",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mcoughlin231654@dulyhealthandcare.direct-ci.com",
"affiliation": "N",
"address_1": "17495 La Grange Rd",
"city": "Tinley Park",
"state": "IL",
"country_code": "US",
"postal_code": "604877581",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.