Individual provider Active NPI

Eric M Sparks, MPT

  • Physical Therapist
  • Peoria, IL
National Provider Identifier
1609927235
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014114 Issued in IL
Practice address
3714 N Prospect Rd
Peoria, IL 61614-7743
Phone
(309) 550-7888
Fax
(309) 550-7848
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 070014114 IL Primary

Addresses

Primary practice location

3714 N Prospect Rd
Peoria, IL 61614-7743

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6250

Other practice location 1

114 N Vine St
Urbana, IL 61802-2700
Phone (217) 352-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070202000092 IL Practitioner - Physical Therapist in Private Practice 8628070737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
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)

103 E Kent St
Streator, IL 61364-2288
Phone (815) 673-1770

1913 W Townline Rd
Peoria, IL 61615-1621
Phone (309) 550-7888

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

3289 Court St
Pekin, IL 61554-6208
Phone (309) 347-0090

3531 W Willow Knolls Dr
Peoria, IL 61614-1078
Phone (309) 683-6900

3714 N Prospect Rd
Peoria, IL 61614-7743
Phone (309) 550-7888

407 N Lagrange Rd
Lagrange Park, IL 60526-5623
Phone (708) 482-9320

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

State licenses

LicenseStateTypeSpecialty
070014114ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jun 12, 2017 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jun 12, 2017 Accepting new patients

Locations

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

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

3714 N Prospect Rd
Peoria, IL 61614
Phone (309) 550-7888

3616 N Main St
Rockford, IL 61103
Phone (815) 877-5932

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

114 N Vine St
Urbana, IL 61802
Phone (217) 352-3300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609927235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 N PROSPECT RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147743",
            "telephone_number": "309-550-7888",
            "fax_number": "309-550-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 N Vine St",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618022700",
            "country_code": "US",
            "telephone_number": "217-352-3300",
            "fax_number": "317-344-4465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "ERIC",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.