Individual provider Active NPI

Zubin S Tantra, PT, FAAOMPT

  • Physical Therapist
  • Mundelein, IL
National Provider Identifier
1417040411
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-006952 Issued in IL
Practice address
511 E Hawley St
Mundelein, IL 60060-2419
Phone
(847) 543-7604
Fax
(847) 543-7605
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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 070-006952 IL Primary

Addresses

Primary practice location

511 E Hawley St
Mundelein, IL 60060-2419

Mailing address

511 E Hawley St
Mundelein, IL 60060-2419
Phone (847) 543-7604

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802000161 IL Practitioner - Physical Therapist in Private Practice 0042101214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake County Physical Therapy LLCGroup PAC ID 6901797166, 3 clinicians

Practice addresses (Care Compare)

1721 Moon Lake Blvd
Suite 105
Hoffman Estates, IL 60169-1070
Phone (224) 653-9989

511 E Hawley St
Mundelein, IL 60060-2419
Phone (847) 543-7604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-006952ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Physical Therapy LLC Physical Therapist CurrentSince Apr 22, 1999 Accepting new patients

Locations

3535 E New York St
Ste 117
Aurora, IL 60504
Phone (630) 381-1381

511 E Hawley St
Mundelein, IL 60060
Phone (847) 201-7612

301 E Rollins Rd
Round Lake Beach, IL 60073
Phone (847) 201-7612

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1417040411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E HAWLEY ST",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600602419",
            "telephone_number": "847-543-7604",
            "fax_number": "847-543-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E HAWLEY ST",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600602419",
            "telephone_number": "847-543-7604",
            "fax_number": "847-543-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTRA",
        "first_name": "ZUBIN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PT,  FAAOMPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-006952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.