Individual provider Active NPI

Claire Kelly

  • Physical Therapist
  • Berwyn, IL
National Provider Identifier
1720497829
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070020972 Issued in IL
Practice address
6347 Cermak Rd
Suite a
Berwyn, IL 60402-4200
Phone
(708) 749-2566
Fax
(708) 749-2498
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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 070020972 IL Primary

Addresses

Primary practice location

6347 Cermak Rd
Suite a
Berwyn, IL 60402-4200

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6200

Other names 1

  • Claire Sapko Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113001250 IL Practitioner - Physical Therapist in Private Practice 7012139728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centre Physical Therapy Riverside LLCGroup PAC ID 6901203074, 5 clinicians

Practice addresses (Care Compare)

1 Riverside Rd
Suite 107
Riverside, IL 60546-2276
Phone (708) 210-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Aug 26, 2014 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 26, 2014 Accepting new patients
Pelviccore Physical Therapy and Wellness Current Accepting new patients
Centre Physical Therapy Riverside LLC Physical Therapist CurrentSince Oct 29, 2021 Accepting new patients

Locations

6347 Cermak Rd
Ste A
Berwyn, IL 60402
Phone (708) 749-2566

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

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

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

207 Harrison St
Oak Park, IL 60304
Phone (312) 391-8752

1 Riverside Rd
Ste 107
Riverside, IL 60546
Phone (708) 210-9800

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1720497829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200",
            "fax_number": "630-928-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6347 CERMAK RD",
            "address_2": "SUITE A",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604024200",
            "telephone_number": "708-749-2566",
            "fax_number": "708-749-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070020972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAIRE",
            "last_name": "SAPKO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.