Nelli Ban

Individual provider Active NPI Physical Therapist · Buffalo Grove, IL

NPI 1710434832 · NPPES record last updated Sep 23, 2016

Key facts

NPI
1710434832
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070018194 (IL)
Practice address
1691 Weiland Rd
Buffalo Grove, IL 60089-6887
Phone
(847) 691-0962
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cadence Physical Therapy Co (8 clinicians)

Practice addresses (Care Compare)

1300 Busch Pkwy
Buffalo Grove, IL 60089-4505
Phone (847) 378-4970

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161212002388 IL Practitioner - Physical Therapist in Private Practice 6305126228 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Cadence Physical Therapy Co Physical Therapist Current
since Nov 1, 2016
Accepting new patients
Prime Medical Clinic S.C. Current
since Jun 29, 2018
Accepting new patients

Locations

1300 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 378-4970

1691 Weiland Rd
Buffalo Grove, IL 60089
Phone (847) 378-4970

3633 W Lake Ave
Ste 307
Glenview, IL 60026
Phone (847) 626-8722

333 Busse Hwy
Unit 1418
Park Ridge, IL 60068

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070018194 IL Yes

Addresses

Primary practice location

1691 Weiland Rd
Buffalo Grove, IL 60089-6887

Mailing address

1691 Weiland Rd
Buffalo Grove, IL 60089
Phone (847) 691-0962

Other providers in Buffalo Grove, IL

All providers in Buffalo Grove, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.