Individual provider Active NPI

Gina Anderson, DPT

  • Physical Therapist
  • La Grange Park, IL
National Provider Identifier
1407997299
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014581 Issued in IL
Practice address
407 N la Grange Rd
La Grange Park, IL 60526-5623
Phone
(708) 482-9320
Fax
(708) 482-9760
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 070014581 IL Primary

Addresses

Primary practice location

407 N la Grange Rd
La Grange Park, IL 60526-5623

Mailing address

407 N la Grange Rd
La Grange Park, IL 60526-5623

Other practice location 1

6502 Joliet Rd Ste B
Countryside, IL 60525-4613
Phone (708) 352-0547

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120806000921 IL Practitioner - Physical Therapist in Private Practice 7810143963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
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)

407 N Lagrange Rd
Lagrange Park, IL 60526-5623
Phone (708) 482-9320

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

6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547

1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440

407 N La Grange Rd
La Grange Park, IL 60526
Phone (708) 482-9320

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

300 S State St
Marengo, IL 60152
Phone (815) 568-4550

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1407997299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N LA GRANGE RD",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605265623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N LA GRANGE RD",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605265623",
            "telephone_number": "708-482-9320",
            "fax_number": "708-482-9760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6502 Joliet Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Countryside",
            "state": "IL",
            "postal_code": "605254613",
            "country_code": "US",
            "telephone_number": "708-352-0547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GINA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.