Organization Active NPI

Therapy Plus PC

  • Specialist
  • Chicago, IL
National Provider Identifier
1285635532
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
070-010042 Issued in IL
Legal business name
THERAPY PLUS PC
Practice address
4733 N Damen Ave
Chicago, IL 60625-1442
Phone
(773) 743-4881
Fax
(773) 751-2878
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Betty Carreno, LPTNPI 1831251073
Title
Owner
Phone
(773) 316-5305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 070-010042 IL Primary

Addresses

Primary practice location

4733 N Damen Ave
Chicago, IL 60625-1442

Mailing address

4733 N Damen Ave
Chicago, IL 60625-1442
Phone (773) 743-4881

Other identifiers 1

IdentifierTypeStateIssuer
325782922001MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040827001204 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3779558259 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2734 N Milwaukee Ave
Ste 106
Chicago, IL 60647
Phone (773) 342-8401

1505 W Devon Ave
Chicago, IL 60660
Phone (773) 316-5305

2930 Mannheim Rd
Franklin Park, IL 60131
Phone (708) 798-0800

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1285635532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251442",
            "telephone_number": "773-743-4881",
            "fax_number": "773-751-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4733 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251442",
            "telephone_number": "773-743-4881",
            "fax_number": "773-751-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY PLUS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "CARRENO",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-316-5305",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "070-010042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325782922001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.