Individual provider Active NPI

Sooby Teresa Joseph, P.T.

  • Physical Therapist
  • Orland Park, IL
National Provider Identifier
1780660555
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-013978 Issued in IL
Practice address
14315 108TH Ave
Suite 215
Orland Park, IL 60467-5700
Phone
(708) 460-8080
Fax
(708) 460-8863
NPI assigned
Dec 22, 2005
Last updated
Jul 21, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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 070-013978 IL Primary

Addresses

Primary practice location

14315 108TH Ave
Suite 215
Orland Park, IL 60467-5700

Mailing address

361 S Frontage Rd
Suite 124
Burr Ridge, IL 60527-5830
Phone (630) 920-4670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-013978ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy PC Physical Therapist PastSince Jul 6, 2009 Accepting new patients
Premier Therapy, LLC Physical Therapist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1780660555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 S FRONTAGE RD",
            "address_2": "SUITE 124",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275830",
            "telephone_number": "630-920-4670",
            "fax_number": "630-920-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14315 108TH AVE",
            "address_2": "SUITE 215",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675700",
            "telephone_number": "708-460-8080",
            "fax_number": "708-460-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "SOOBY",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-013978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.