Individual provider Active NPI

Joerlyn Josiephine Lazo, DPT

  • Physical Therapist
  • Gurnee, IL
National Provider Identifier
1316539125
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.025533 Issued in IL
Practice address
34498 N Old Walnut Cir Ste Ab
Gurnee, IL 60031-4601
Phone
(224) 688-5897
NPI assigned
Feb 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 070.025533 IL Primary

Addresses

Primary practice location

34498 N Old Walnut Cir Ste Ab
Gurnee, IL 60031-4601

Mailing address

780 Weidner Rd
Buffalo Grove, IL 60089-4739
Phone (224) 628-0475

Other practice location 1

1037 E Woodfield Rd
Schaumburg, IL 60173-4706
Phone (847) 752-4492

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210306000032 IL Practitioner - Physical Therapist in Private Practice 6800202433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fyzical Gurnee Clinical PLLCGroup PAC ID 2668828443, 4 clinicians

Practice addresses (Care Compare)

34498 N Old Walnut Cir
Suite a
Gurnee, IL 60031-4202
Phone (224) 252-2922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.025533ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Naveed H Elahi DC SC CurrentSince Feb 15, 2021 Accepting new patients
Fyzical Gurnee Clinical PLLC Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients
Satosan LLC CurrentSince Oct 7, 2024 Accepting new patients

Locations

34498 N Old Walnut Cir
Ste A
Gurnee, IL 60031
Phone (224) 252-2922

1037 E Woodfield Rd
Schaumburg, IL 60173
Phone (847) 466-7392

Organizations & group practices 3

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": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1316539125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 WEIDNER RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894739",
            "telephone_number": "224-628-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34498 N OLD WALNUT CIR STE AB",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314601",
            "telephone_number": "224-688-5897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1037 E Woodfield Rd",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734706",
            "country_code": "US",
            "telephone_number": "847-752-4492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZO",
        "first_name": "JOERLYN",
        "middle_name": "JOSIEPHINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.