Individual provider Active NPI

Kieran J Tobin, DPT

  • Physical Therapist
  • Evanston, IL
National Provider Identifier
1376985127
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-025418 Issued in IL
Practice address
522 Main St
Evanston, IL 60202-1815
Phone
(847) 475-1630
Fax
(847) 475-1631
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Physical Therapist 225100000X 070-025418 IL Primary

Addresses

Primary practice location

522 Main St
Evanston, IL 60202-1815

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201214001151 IL Practitioner - Physical Therapist in Private Practice 8325450471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Northwestern University Feinberg Medical School, 2020
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)

522 Main St
Evanston, IL 60202-1815
Phone (847) 475-1630

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
070-025418ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Nov 9, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince May 4, 2021 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist CurrentSince Nov 9, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince May 4, 2021 Accepting new patients

Locations

12052 S Cicero Ave
Alsip, IL 60803
Phone (708) 489-9940

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

522 Main St
Evanston, IL 60202
Phone (847) 475-1360

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

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

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

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

426 E 162nd St
South Holland, IL 60473
Phone (708) 333-0677

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743

Organizations & group practices 4

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1376985127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 MAIN ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021815",
            "telephone_number": "847-475-1630",
            "fax_number": "847-475-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "KIERAN",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-025418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.