Individual provider Active NPI

Andrea Lacoy Lee

  • Physical Therapist
  • Tinley Park, IL
National Provider Identifier
1235398512
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070016524 Issued in IL
Practice address
17837 S 80TH Ave
Tinley Park, IL 60477
Phone
(708) 342-2500
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 070016524 IL Primary

Addresses

Primary practice location

17837 S 80TH Ave
Tinley Park, IL 60477

Mailing address

2784 Bluestone Bay Drive
New Lenox, IL 60451
Phone (708) 846-2001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120822000353 IL Practitioner - Physical Therapist in Private Practice 1254588528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1938 E Lincoln Hwy 111
New Lenox, IL 60451-3929
Phone (815) 485-2916

19801 Governors Hwy
Suite 100
Flossmoor, IL 60422-4363
Phone (708) 647-1500

19843 Wolf Rd
Mokena, IL 60448-1315
Phone (708) 478-0320

407 N Lagrange Rd
Lagrange Park, IL 60526-5623
Phone (708) 482-9320

4249 Lincoln Hwy
Matteson, IL 60443-2474
Phone (708) 481-2323

722 N McLean Blvd
South Elgin, IL 60177-1429
Phone (847) 695-5088

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jul 1, 2012 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 1, 2012 Accepting new patients

Locations

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

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

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

17837 80th Ave
Tinley Park, IL 60477
Phone (708) 342-2500

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235398512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2784 BLUESTONE BAY DRIVE",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "708-846-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17837 S 80TH AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60477",
            "telephone_number": "708-342-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDREA",
        "middle_name": "LACOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jul 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.

Verify at the official NPI Registry.