Individual provider Active NPI

Jomhar Vallejo Solis, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1861119638
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070027019 Issued in IL
Practice address
1333 W Belmont Ave Ste 350
Chicago, IL 60657-5785
Phone
(630) 933-1500
Fax
(312) 926-1377
NPI assigned
Oct 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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 070027019 IL Primary

Addresses

Primary practice location

1333 W Belmont Ave Ste 350
Chicago, IL 60657-5785

Mailing address

1333 W Belmont Ave Ste 350
Chicago, IL 60657-5785
Phone (630) 933-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709003645 IL Practitioner - Physical Therapist in Private Practice 9133664683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1333 W Belmont Ave
Suite 350
Chicago, IL 60657-5785
Phone (312) 694-9362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070027019ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 26, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 26, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

1333 W Belmont Ave
Ste 350
Chicago, IL 60657
Phone (312) 921-0330

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1861119638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W BELMONT AVE STE 350",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575785",
            "telephone_number": "630-933-1500",
            "fax_number": "312-926-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W BELMONT AVE STE 350",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575785",
            "telephone_number": "630-933-1500",
            "fax_number": "312-926-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIS",
        "first_name": "JOMHAR",
        "middle_name": "VALLEJO",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027019",
            "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 Aug 8, 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.