Individual provider Active NPI

Michelle Neri

  • Physical Therapist
  • Bolingbrook, IL
National Provider Identifier
1811712870
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07001993 Issued in IL
Practice address
1934 Norwich LN
Bolingbrook, IL 60490-5514
Phone
(708) 420-2594
NPI assigned
Nov 15, 2024
Last updated
Nov 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 07001993 IL Primary

Addresses

Primary practice location

1934 Norwich LN
Bolingbrook, IL 60490-5514

Mailing address

1934 Norwich LN
Bolingbrook, IL 60490-5514

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241202000087 IL Practitioner - Physical Therapist in Private Practice 0749715662 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
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

407 W 63Rd St
Sunrise of Westmont
Westmont, IL 60559-2910
Phone (331) 224-0769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001993ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Oct 21, 2024 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Oct 21, 2024 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

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": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1811712870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 NORWICH LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 NORWICH LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905514",
            "telephone_number": "708-420-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERI",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "07001993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.