Individual provider Active NPI

Jennifer Lundeen

  • Physical Therapist
  • Oakbrook Terrace, IL
National Provider Identifier
1386818953
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.014442 Issued in IL
Practice address
17W682 Butterfield Rd Ste 102
Oakbrook Terrace, IL 60181-4029
Phone
(630) 909-7378
Fax
(630) 909-7371
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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 070.014442 IL Primary

Addresses

Primary practice location

17W682 Butterfield Rd Ste 102
Oakbrook Terrace, IL 60181-4029

Mailing address

109 E Jackson St
Villa Park, IL 60181-3252
Phone (630) 440-1551

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415001427 IL Practitioner - Physical Therapist in Private Practice 4082022876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Saint Louis University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

1000 Sunset Ridge Rd
Northbrook, IL 60062-4008
Phone (224) 300-7284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.014442ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Physical Therapist CurrentSince Apr 8, 2021 Accepting new patients

Locations

28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 413-5817

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

Organizations & group practices 1

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": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1386818953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E JACKSON ST",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813252",
            "telephone_number": "630-440-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17W682 BUTTERFIELD RD STE 102",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814029",
            "telephone_number": "630-909-7378",
            "fax_number": "630-909-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDEEN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.014442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.