Individual provider Active NPI

Anthony R Serpe, DPT

  • Physical Therapist
  • Carol Stream, IL
National Provider Identifier
1558692467
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-017420 Issued in IL
Practice address
327 Gundersen Dr
Suite C
Carol Stream, IL 60188-2402
Phone
(630) 784-3251
NPI assigned
Jan 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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 070-017420 IL Primary

Addresses

Primary practice location

327 Gundersen Dr
Suite C
Carol Stream, IL 60188-2402

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 1

IdentifierTypeStateIssuer
P00844078OtherILMEDICARE RR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100306000364 IL Practitioner - Physical Therapist in Private Practice 2264577824 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brady, P.C.Group PAC ID 2163508227, 14 clinicians

Practice addresses (Care Compare)

1309 Macom Dr
Suite 105
Naperville, IL 60564-3206
Phone (815) 676-3856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-017420ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jun 22, 2019 Accepting new patients
Brady, P.C. Physical Therapist CurrentSince Oct 17, 2022 Accepting new patients

Locations

2340 S Eola Rd
Ste 104
Aurora, IL 60503
Phone (630) 978-9200

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

218 N Bolingbrook Dr
Bolingbrook, IL 60440
Phone (630) 972-1541

790 Remington Blvd
Bolingbrook, IL 60440

1337 Lily Cache Ln
Bolingbrook, IL 60490
Phone (630) 226-5110

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

1309 Macom Dr
Ste 105
Naperville, IL 60564
Phone (815) 676-3856

12640 S Route 59
Unit 110
Plainfield, IL 60585
Phone (815) 676-3905

967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1558692467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 GUNDERSEN DR",
            "address_2": "SUITE C",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882402",
            "telephone_number": "630-784-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERPE",
        "first_name": "ANTHONY",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-18",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-017420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00844078",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.