Individual provider Active NPI

Lucia Susana Valenzuela, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1871227744
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.026650 Issued in IL
Practice address
4307 S Pulaski Rd
Chicago, IL 60632-4008
Phone
(773) 916-4673
Fax
(773) 847-7868
NPI assigned
Jul 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 302364 CA
Physical Therapist 225100000X 65106 OR
Physical Therapist 225100000X 070.026650 IL Primary

Addresses

Primary practice location

4307 S Pulaski Rd
Chicago, IL 60632-4008

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

3611 Nm 528 NW Ste 101
Albuquerque, NM 87114-8920
Phone (505) 217-2826

Other practice location 2

12400 High Bluff Dr
San Diego, CA 92130-3077
Phone (866) 871-8519

Other practice location 3

1630 Beavercreek Rd Ste A
Oregon City, OR 97045-4156
Phone (503) 607-0047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230628003585 CA Practitioner - Physical Therapist in Private Practice 4880065473 Reassigns benefits to 1 organization
I20231110001284 OR Practitioner - Physical Therapist in Private Practice 4880065473 Reassigns benefits to 1 organization
I20240516000946 IL Practitioner - Physical Therapist in Private Practice 4880065473 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
New Proactive LLCGroup PAC ID 7315218708, 53 clinicians

Practice addresses (Care Compare)

1630 Beavercreek Rd
Suite a
Oregon City, OR 97045-4156
Phone (503) 607-0047

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
302364CAMDPhysical Therapist
070.026650ILMDPhysical Therapist
65106ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Proactive LLC Physical Therapist CurrentSince Oct 23, 2023 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist CurrentSince Jun 3, 2024 Accepting new patients
H.D.P.R.G., Inc Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Jun 3, 2024 Accepting new patients
Omnis Omnia Inc. PastSince Feb 4, 2015 Accepting new patients

Locations

5930 Adobe Rd
Twentynine Palms, CA 92277
Phone (760) 367-1743

56299 29 Palms Hwy
Yucca Valley, CA 92284
Phone (760) 367-1743

790 Remington Blvd
Bolingbrook, IL 60440

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

4307 S Pulaski Rd
Chicago, IL 60632
Phone (773) 916-4673

1340 E 47th St
Chicago, IL 60653
Phone (773) 496-5147

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

4732 Dempster St
Skokie, IL 60076
Phone (224) 534-2280

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

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

1630 Beavercreek Rd
Ste A
Oregon City, OR 97045
Phone (503) 607-0047

450 NW Greenwood Ave
Redmond, OR 97756
Phone (541) 923-0410

Organizations & group practices 5

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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1871227744",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324008",
            "telephone_number": "773-916-4673",
            "fax_number": "773-847-7868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3611 Nm 528 NW Ste 101",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871148920",
            "country_code": "US",
            "telephone_number": "505-217-2826",
            "fax_number": "505-234-7431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12400 High Bluff Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921303077",
            "country_code": "US",
            "telephone_number": "866-871-8519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 Beavercreek Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970454156",
            "country_code": "US",
            "telephone_number": "503-607-0047",
            "fax_number": "503-607-0051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "LUCIA",
        "middle_name": "SUSANA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302364",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65106",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.026650",
            "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 Apr 29, 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.