Rebecca Ellis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-014813 Issued in IL

Practice address

301 E Rollins Rd
Round Lake Beach, IL 60073-1331

Phone

(847) 201-7612

Fax

(847) 201-7613

NPI assigned

Sep 22, 2006

Last updated

Aug 21, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake County Physical Therapy LLCGroup PAC ID 6901797166, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lake County Physical Therapy LLC

  • Physical Therapist
  • Mundelein, IL
  • NPI 1851487581
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1750480711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731331",
            "telephone_number": "847-201-7612",
            "fax_number": "847-201-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731331",
            "telephone_number": "847-201-7612",
            "fax_number": "847-201-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "REBECCA",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renita Dercel Davis, MSW, MED
• Dental Professionals of Illinois, PC (Dental Care of Round Lake Beach)
• DM Family Dentistry Inc
• Dr. Dans Chiropractic Services
• Sharice Ellenwood
• Ermil Wagner, D.O. P.C.
• Marlene A Espinosa
• Family Medicine Specialists of Round Lake Incorporated S C
• Jennifer Farinosi, RDH
• Nicole C Fishback, RDH

• Physical Therapist in Round Lake Beach, IL
• Providers in Round Lake Beach, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.