Active NPI
Douglas K Elliott, PT
- Physical Therapist
- South Holland, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070015321
- Practice address
- 426 E 162ND St
South Holland, IL 60473-2258 - Phone
- (708) 333-0677
- Fax
- (708) 333-1170
- NPI assigned
- May 22, 2008
- Sex
- Male
- 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 | 070015321 | IL | Primary |
Addresses
Primary practice location
426 E 162ND St
South Holland, IL 60473-2258
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2036 E Beltline Ave NE a
Ati Physical Therapy
Grand Rapids, MI 49525-8702
Phone (616) 885-1194
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.78 of 100
- Quality
- 89.5
- Improvement activities
- 40
- Cost
- 71.87
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Rehabilitation Specialists of Fowlerville LLC | Physical Therapist | Current | Accepting new patients |
| Michigan Rehabilitation Specialists of Fowlerville, LLC | Current | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710
20095 Gilbert Rd
Ste B
Big Rapids, MI 49307
Phone (231) 408-3208
4050 Alpine Ave NW
Comstock Park, MI 49321
Phone (616) 552-9566
10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200
2036 E Beltline Ave NE
Ste A
Grand Rapids, MI 49525
Phone (616) 885-1194
4520 Ivanrest Ave SW
Ste A
Grandville, MI 49418
11595 E Lakewood Blvd
Ste 80
Holland, MI 49424
Phone (616) 594-2000
12365 James St
Ste 30
Holland, MI 49424
Phone (616) 510-2179
5251 Harvey St
Ste 100
Norton Shores, MI 49444
Phone (231) 246-4379
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.
-
- Physical Therapist
- Fowlerville, MI
- NPI 1669531166
-
- Durable Medical Equipment & Medical Supplies
- Dexter, MI
- NPI 1407525892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500336000000",
"number": "1699932970",
"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": "426 E 162ND ST",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604732258",
"telephone_number": "708-333-0677",
"fax_number": "708-333-1170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "DOUGLAS",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-22",
"last_updated": "2017-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070015321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Holland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.