Individual provider Active NPI

Bradley Daley, MPT

  • Physical Therapist
  • Gurnee, IL
National Provider Identifier
1376684555
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070013556 Issued in IL
Practice address
30 Tower CT
Suite a
Gurnee, IL 60031-3322
Phone
(847) 336-1520
Fax
(847) 336-1098
NPI assigned
Feb 9, 2007
Last updated
Oct 13, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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 070013556 IL Primary

Addresses

Primary practice location

30 Tower CT
Suite a
Gurnee, IL 60031-3322

Mailing address

30 Tower CT
Suite a
Gurnee, IL 60031-3322
Phone (847) 336-1520

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120726000187 IL Practitioner - Physical Therapist in Private Practice 3274799861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
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)

1870 E Grand Ave
Lindenhurst, IL 60046-7821
Phone (224) 643-0117

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

30 Tower Ct
Ste A
Gurnee, IL 60031
Phone (847) 336-1520

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

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1376684555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 TOWER CT",
            "address_2": "SUITE A",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313322",
            "telephone_number": "847-336-1520",
            "fax_number": "847-336-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 TOWER CT",
            "address_2": "SUITE A",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313322",
            "telephone_number": "847-336-1520",
            "fax_number": "847-336-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEY",
        "first_name": "BRADLEY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013556",
            "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 13, 2009; 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.