Active NPI
Elizabeth Eberts
- Physical Therapist
- Bolingbrook, IL
National Provider Identifier
1205298569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT025116
- Practice address
- 790 Remington Blvd
Bolingbrook, IL 60440-4909 - Phone
- (630) 296-2223
- Fax
- (630) 759-9510
- NPI assigned
- Mar 25, 2016
- Last updated
- Nov 11, 2022
- 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 | PT025116 | PA | Primary |
Addresses
Primary practice location
790 Remington Blvd
Bolingbrook, IL 60440-4909
Mailing address
4304 5TH Street Hwy
Unit 4
Temple, PA 19560-1740
Phone (484) 220-2912
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT025116 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668124800000",
"number": "1205298569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4304 5TH STREET HWY",
"address_2": "UNIT 4",
"city": "TEMPLE",
"state": "PA",
"postal_code": "195601740",
"telephone_number": "484-220-2912",
"fax_number": "610-929-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERTS",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-25",
"last_updated": "2022-11-11",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT025116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.