Individual provider Active NPI

Elizabeth Ann Niedoborski, PT

  • Physical Therapist
  • Joliet, IL
National Provider Identifier
1790957702
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.016241 Issued in IL
Practice address
3082 Caton Farm Rd
Joliet, IL 60435-1455
Phone
(815) 577-9936
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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 070.016241 IL Primary

Addresses

Primary practice location

3082 Caton Farm Rd
Joliet, IL 60435-1455

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090727000730 IL Practitioner - Physical Therapist in Private Practice 3779636501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
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

1240 Route 34
Oswego, IL 60543-8939
Phone (630) 978-6218

1275 N Convent St
Suite 3
Bourbonnais, IL 60914-8211
Phone (815) 936-1855

1296 W Boughton Rd
Bolingbrook, IL 60490-1554
Phone (630) 771-0850

218 N Bolingbrook Dr
Bolingbrook, IL 60440-2386
Phone (630) 972-1541

2940 Rollingridge Rd
Suite 100
Naperville, IL 60564-4233
Phone (630) 369-4771

Merit-based Incentive Payment System (MIPS)

Final score
85.61 of 100Reported as group
Quality
90
Improvement activities
40
Cost
70.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.016241ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Naperville, LLC Physical Therapist CurrentSince May 21, 2012 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince May 21, 2012 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince May 21, 2012 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist Current Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current Accepting new patients
Athletic & Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince May 21, 2012 Accepting new patients

Locations

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

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

3082 Caton Farm Rd
Joliet, IL 60435
Phone (630) 783-2001

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

790 Royal Saint George Dr
Ste 124
Naperville, IL 60563
Phone (630) 355-5255

1212 S Naper Blvd
Ste 104
Naperville, IL 60540
Phone (630) 369-2340

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1790957702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3082 CATON FARM RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351455",
            "telephone_number": "815-577-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDOBORSKI",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.016241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.