Active NPI
Anna Bullman
- Physical Therapist
- Grayslake, IL
National Provider Identifier
1619084878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-010454
- Practice address
- 1275 E Belvidere Rd
Suite 150
Grayslake, IL 60030-2082 - Phone
- (847) 735-0828
- Fax
- (847) 735-0838
- NPI assigned
- Aug 24, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-010454 | IL | Primary |
Addresses
Primary practice location
1275 E Belvidere Rd
Suite 150
Grayslake, IL 60030-2082
Mailing address
900 Rand Rd
Suite 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-010454 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Reilly M.D. Holistic & Family Practice Medicine LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Fox River Grove, IL
- NPI 1598871923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401408000000",
"number": "1619084878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 RAND RD",
"address_2": "SUITE 300",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600162359",
"telephone_number": "847-324-3976",
"fax_number": "847-929-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 E BELVIDERE RD",
"address_2": "SUITE 150",
"city": "GRAYSLAKE",
"state": "IL",
"postal_code": "600302082",
"telephone_number": "847-735-0828",
"fax_number": "847-735-0838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLMAN",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2014-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-010454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grayslake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.