Individual provider Active NPI

Colleen M Levitz, MSPT

  • Physical Therapist
  • Northbrook, IL
National Provider Identifier
1558344911
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4507745 Issued in IL
Practice address
666 Dundee Rd
Suite 1002
Northbrook, IL 60062-2727
Phone
(847) 714-7400
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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 4507745 IL Primary

Addresses

Primary practice location

666 Dundee Rd
Suite 1002
Northbrook, IL 60062-2727

Mailing address

666 Dundee Rd
Suite 1002
Northbrook, IL 60062-2727
Phone (847) 714-7400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131014000553 IL Practitioner - Physical Therapist in Private Practice 6204845852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

666 Dundee Rd
Suite 1002
Northbrook, IL 60062-2735
Phone (847) 714-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22507MDMDPharmacist
4507745ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Fitness and Rehabilitation/Rebound Sports Medicine Physical Therapist CurrentSince Aug 22, 2010 Accepting new patients
Prescription Orthopedic and Sports Therapy Physical Therapist Past Accepting new patients

Locations

246 E Janata Blvd
Ste 135
Lombard, IL 60148
Phone (630) 376-6096

666 Dundee Rd
Ste 1002
Northbrook, IL 60062
Phone (847) 714-7400

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, 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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1558344911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 1002",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-714-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 1002",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-714-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVITZ",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "4507745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; 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.