NPIMap

Organization Active NPI

Mobile Therapy Center of America, LLC

  • Multi-Specialty Clinic/Center
  • Libertyville, IL
National Provider Identifier
1225064488
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MOBILE THERAPY CENTER OF AMERICA, LLC
Practice address
854 Technology Way
Libertyville, IL 60048-5350
Phone
(847) 816-7200
Fax
(847) 816-7210
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jason Newman
Title
Owner
Phone
(224) 354-1290

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

854 Technology Way
Libertyville, IL 60048-5350

Mailing address

854 Technology Way
Libertyville, IL 60048-5350
Phone (847) 816-7200

National Provider Directory

National Provider Directory

Locations

200 Abbott Park Rd
Abbott Park, IL 60064
Phone (847) 935-8755

1870 W Winchester Rd
Ste 203
Libertyville, IL 60048
Phone (847) 816-7000

854 Technology Way
Ste C
Libertyville, IL 60048

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1225064488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 TECHNOLOGY WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485350",
            "telephone_number": "847-816-7200",
            "fax_number": "847-816-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 TECHNOLOGY WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485350",
            "telephone_number": "847-816-7200",
            "fax_number": "847-816-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE THERAPY CENTER OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-354-1290"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.