Active NPI
Betsy Jolly, PT
- Physical Therapist
- Buffalo Grove, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070017531
- Practice address
- 604 Buckthorn Ter
Buffalo Grove, IL 60089-1832 - Phone
- (630) 935-6756
- NPI assigned
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 019862 | PA | |
| Physical Therapist | 225100000X | 070017531 | IL | Primary |
Addresses
Primary practice location
604 Buckthorn Ter
Buffalo Grove, IL 60089-1832
Mailing address
604 Buckthorn Ter
Buffalo Grove, IL 60089-1832
Phone (630) 935-6756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230117001884 | IL | Practitioner - Physical Therapist in Private Practice | 9739550468 | Reassigns benefits to 2 organizations |
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
- Council for Jewish ElderlyIllinois Home Therapy LLC
Practice addresses (Care Compare)
1601 Lake Cook Rd
Deerfield, IL 60015-5271
Phone (773) 508-4475
8140 McCormick Blvd
Suite 141
Skokie, IL 60076-2920
Phone (917) 751-8706
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070017531 | IL | MD | Physical Therapist |
| 019862 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Home Therapy LLC | Physical Therapist | Current | Accepting new patients |
| Council for Jewish Elderly | Current | Accepting new patients | |
| Agape Health Services LLC | Physical Therapist | Current | Accepting new patients |
| Council for Jewish Elderly | Current | Accepting new patients | |
| Voyage Staffing | Past | Accepting new patients |
Locations
3003 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000
1601 Lake Cook Rd
Deerfield, IL 60015
Phone (773) 508-4475
8140 McCormick Blvd
Ste 141
Skokie, IL 60076
Phone (833) 272-8624
Organizations & group practices 6
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.
-
- Physical Therapist
- Buffalo Grove, IL
- NPI 1003591025
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1619907698
-
- Adult Day Care Clinic/Center
- Evanston, IL
- NPI 1619921566
-
- Nursing Care Agency
- Heathrow, FL
- NPI 1316133788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686960000000",
"number": "1447488481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 BUCKTHORN TER",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600891832",
"telephone_number": "630-935-6756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 BUCKTHORN TER",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600891832",
"telephone_number": "630-935-6756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLY",
"first_name": "BETSY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-29",
"last_updated": "2023-06-17",
"certification_date": "2023-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "019862",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070017531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Buffalo Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.