Individual provider Active NPI

Deborah A Revolta, PT

  • Physical Therapist
  • Algonquin, IL
National Provider Identifier
1770829822
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070004196 Issued in IL
Practice address
770 S Randall Rd
Algonquin, IL 60102-5915
Phone
(224) 209-5051
NPI assigned
Dec 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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 070004196 IL Primary

Addresses

Primary practice location

770 S Randall Rd
Algonquin, IL 60102-5915

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 1

IdentifierTypeStateIssuer
P01347894OtherILRAILROAD PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130301000186 IL Practitioner - Physical Therapist in Private Practice 4385632082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

109 W Geneva Rd
Wheaton, IL 60187-9141
Phone (630) 784-3251

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
90
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070004196ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current Accepting new patients
Athletic & Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Oct 8, 2019 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist CurrentSince Oct 26, 2018 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Oct 26, 2018 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Oct 8, 2019 Accepting new patients
Accelerated Rehabilitation Centers LTD Physical Therapist Past Accepting new patients

Locations

770 S Randall Rd
Algonquin, IL 60102
Phone (224) 209-5051

420 W Northwest Hwy
Ste B
Barrington, IL 60010
Phone (847) 382-3864

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

573 W State Route 22
Lake Zurich, IL 60047
Phone (847) 796-3320

1612 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 281-0323

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743

Organizations & group practices 6

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": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1770829822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 S RANDALL RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025915",
            "telephone_number": "224-209-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVOLTA",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070004196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "P01347894",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.