Individual provider Active NPI

Sara D Stotts, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1760490080
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070012487 Issued in IL
Practice address
111 N Wabash Ave
Suite 600
Chicago, IL 60602-1903
Phone
(312) 332-0844
Fax
(312) 332-0847
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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 070012487 IL Primary

Addresses

Primary practice location

111 N Wabash Ave
Suite 600
Chicago, IL 60602-1903

Mailing address

111 N Wabash Ave
Suite 600
Chicago, IL 60602-1903
Phone (312) 332-0844

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060508000223 IL Practitioner - Physical Therapist in Private Practice 9931110913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Medical Group LLCGroup PAC ID 6608887682, 2 clinicians

Practice addresses (Care Compare)

111 N Wabash Ave
Suite 600
Chicago, IL 60602-1950
Phone (312) 332-0844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070012487ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Medical Group, LLC Physical Therapist CurrentSince Dec 1, 2004 Accepting new patients
Thomas Klarquist, PC PastSince Dec 1, 2004 Accepting new patients

Locations

111 N Wabash Ave
Ste 600
Chicago, IL 60602
Phone (312) 332-0844

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1760490080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-332-0844",
            "fax_number": "312-332-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-332-0844",
            "fax_number": "312-332-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTTS",
        "first_name": "SARA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012487",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 6, 2015; 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.