Ashley Cerullo, PT
Individual provider Active NPI Physical Therapist · Homer Glen, IL
NPI 1649535196 · NPPES record last updated Dec 10, 2019
Key facts
- NPI
- 1649535196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 12261 W 159TH St
Homer Glen, IL 60491-7847 - Phone
- (708) 301-2255
- NPI assigned
- Jul 11, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orthopedic Physical Therapy Services LLC
Practice addresses (Care Compare)
409 W Huron St
Suite 300
Chicago, IL 60654-3431
Phone (708) 301-2255
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121207000294 | IL | Practitioner - Physical Therapist in Private Practice | 4688826167 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Physical Therapy Services LLC | Current |
Accepting new patients |
Locations
409 W Huron St
Ste 300
Chicago, IL 60654
Phone (312) 604-2562
12261 W 159th St
Lockport, IL 60491
Phone (708) 301-2255
Interoperability endpoints
- ashley.cerullo.1@28282.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
12261 W 159TH St
Homer Glen, IL 60491-7847
Mailing address
12261 W 159TH St
Homer Glen, IL 60491-7847
Phone (708) 301-2255
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01190975 | Other | IL | MEDICARE RR |
| P01285698 | Other | IL | MEDICARE RAILROAD |
Other names
- Ashley Roxas
Other providers in Homer Glen, IL
- Lauren Caratachea
- Heather Carrero
- Susan A. Carroll
- Zaira Carvajal
- Melanie A Cerinich
- Sudarsana Chakrabarti
- Virginia Diane Chilcutt
- Chiro One Wellness Center of Homer Glen, S.C.
- Chiropractic and Acupunture Center of Homer Glen
- Julianne R Chlipala
All providers in Homer Glen, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.