Individual provider Active NPI

Constance H Vanni, PT

  • Physical Therapist
  • Woodstock, IL
National Provider Identifier
1487764718
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070004961 Issued in IL
Practice address
113 S Eastwood Dr
Woodstock, IL 60098-3519
Phone
(815) 334-0400
Fax
(815) 334-0800
NPI assigned
Aug 30, 2006
Last updated
Feb 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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 070004961 IL Primary

Addresses

Primary practice location

113 S Eastwood Dr
Woodstock, IL 60098-3519

Mailing address

113 S Eastwood Dr
Woodstock, IL 60098-3519
Phone (815) 334-0400

Other identifiers 8

IdentifierTypeStateIssuer
568150OtherILMEDICARE GROUP NUMBER
567700OtherILMEDICARE GROUP NUMBER
DC7571OtherILR R MEDICARE GRP #
P00199532OtherILR R MEDICARE PIN #
568080OtherILMEDICARE GROUP NUMBER
1623066OtherILBCBS PROVIDER #
367885100OtherILUS DEPT OF LABOR PROV #
1619908OtherILBCBS IL GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080709000351 IL Practitioner - Physical Therapist in Private Practice 1153493093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
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)

1294 S Route 12
Fox Lake, IL 60020-1950
Phone (847) 973-9440

200 S Western Ave
Carpentersville, IL 60110-1738
Phone (224) 699-0950

280 N Randall Rd
Lake in the Hills, IL 60156-5903
Phone (847) 854-8219

300 S State St
Marengo, IL 60152-3532
Phone (815) 568-4550

722 N McLean Blvd
South Elgin, IL 60177-1429
Phone (847) 695-5088

750 E Terra Cotta Ave
Suite D
Crystal Lake, IL 60014-3621
Phone (815) 404-2568

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 Feb 15, 2016 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Feb 15, 2016 Accepting new patients
Occusport Services Inc. Physical Therapist Past Accepting new patients

Locations

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

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

113 S Eastwood Dr
Woodstock, IL 60098
Phone (815) 334-0400

Organizations & group practices 3

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1487764718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S EASTWOOD DR",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983519",
            "telephone_number": "815-334-0400",
            "fax_number": "815-334-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S EASTWOOD DR",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983519",
            "telephone_number": "815-334-0400",
            "fax_number": "815-334-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNI",
        "first_name": "CONSTANCE",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070004961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "568150",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "567700",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R R MEDICARE GRP #",
            "identifier": "DC7571",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R R MEDICARE PIN #",
            "identifier": "P00199532",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "568080",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "1623066",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR PROV #",
            "identifier": "367885100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL GROUP NUMBER",
            "identifier": "1619908",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.