Kristopher D Harrison, PHYSICAL THERAPY

Individual provider Active NPI Physical Therapist · Diamond, IL

NPI 1679679187 · NPPES record last updated Nov 29, 2016

Key facts

NPI
1679679187
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070013745 (IL)
Practice address
2595 E Division St
Diamond, IL 60416-9794
Phone
(815) 634-8420
Fax
(815) 634-8430
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletic and Therapeutic Institute of Bourbonnais, LLC (171 clinicians)

Practice addresses (Care Compare)

2595 E Division St
Diamond, IL 60416-9794
Phone (815) 634-8420

Merit-based Incentive Payment System (MIPS)

Final score
85.61 of 100 (group)
Quality
90
Improvement activities
40
Cost
70.36

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040501000215 IL Practitioner - Physical Therapist in Private Practice 7810985785 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070013745ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current
since May 28, 2021
Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist Current
since Jun 29, 2020
Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current
since May 28, 2021
Accepting new patients

Locations

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

790 Remington Blvd
Bolingbrook, IL 60440

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

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

2595 E Division St
Diamond, IL 60416
Phone (815) 634-8420

108 Watters Dr
Dwight, IL 60420
Phone (815) 584-5411

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

4555 Lincoln Hwy
Matteson, IL 60443
Phone (708) 283-0021

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

607 W Jourdan St
Newton, IL 62448
Phone (618) 783-2908

5401 N Knoxville Ave
Ste 117
Peoria, IL 61614
Phone (309) 689-8888

924 W Custer Ave
Pontiac, IL 61764
Phone (815) 844-4690

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

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

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070013745 IL Yes

Addresses

Primary practice location

2595 E Division St
Diamond, IL 60416-9794

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Other providers in Diamond, IL

All providers in Diamond, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.