Individual provider Active NPI

Heather Paulis, MPT

  • Physical Therapist
  • Lisle, IL
National Provider Identifier
1265577670
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014424 Issued in IL
Practice address
5328 Main St
Suite 12
Lisle, IL 60532-4185
Phone
(630) 343-5093
Fax
(630) 343-5095
NPI assigned
Feb 21, 2007
Last updated
Nov 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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 070014424 IL Primary

Addresses

Primary practice location

5328 Main St
Suite 12
Lisle, IL 60532-4185

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120724000624 IL Practitioner - Physical Therapist in Private Practice 9335305085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
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)

1071 E Roosevelt Rd
Wheaton, IL 60187-6609
Phone (630) 682-1785

1256 W Boughton Rd
Bolingbrook, IL 60440-6568
Phone (630) 378-9420

2027 87TH St
Unit C
Woodridge, IL 60517-7400
Phone (630) 783-2300

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

4700 Gilbert Ave
Suite 43a
Western Springs, IL 60558-1670
Phone (703) 783-1044

6860 N Frontage Rd
Suite B
Burr Ridge, IL 60527-7828
Phone 63068641233

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

State licenses

LicenseStateTypeSpecialty
070014424ILMDPhysical Therapist

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

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

1626 Ogden Ave
Downers Grove, IL 60515
Phone (630) 724-0977

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

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

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, 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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1265577670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5328 MAIN ST",
            "address_2": "SUITE 12",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605324185",
            "telephone_number": "630-343-5093",
            "fax_number": "630-343-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULIS",
        "first_name": "HEATHER",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.