Individual provider Active NPI

Emmanuel Y Pera, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1700302080
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070023140 Issued in IL
Practice address
24 E Chicago Ave
Chicago, IL 60611-2009
Phone
(312) 951-9700
Fax
(312) 951-6989
NPI assigned
Aug 17, 2017
Last updated
Feb 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 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 070023140 IL Primary

Addresses

Primary practice location

24 E Chicago Ave
Chicago, IL 60611-2009

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Other identifiers 1

IdentifierTypeStateIssuer
070023140OtherILSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170911001909 IL Practitioner - Physical Therapist in Private Practice 1456624659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Northwestern University Feinberg Medical School, 2017
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)

4607 Golf Rd
Skokie, IL 60076-1209
Phone (847) 673-5073

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
070023140ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Aug 17, 2017 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Nov 6, 2020 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Nov 6, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 17, 2017 Accepting new patients

Locations

24 E Chicago Ave
Chicago, IL 60611
Phone (312) 951-9700

204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225

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

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

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

4607 Golf Rd
Skokie, IL 60076
Phone (847) 673-5073

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

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1700302080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112009",
            "telephone_number": "312-951-9700",
            "fax_number": "312-951-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERA",
        "first_name": "EMMANUEL",
        "middle_name": "Y",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "070023140",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.