Individual provider Active NPI

Mercedes E Lim Sebastian, LPT

  • Physical Therapist
  • McHenry, IL
National Provider Identifier
1871683938
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-009843 Issued in IL
Practice address
1920 N Richmond Rd
Suite a
McHenry, IL 60051-5467
Phone
(815) 271-6811
Fax
(815) 344-8814
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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 070-009843 IL Primary

Addresses

Primary practice location

1920 N Richmond Rd
Suite a
McHenry, IL 60051-5467

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 1

IdentifierTypeStateIssuer
02232425OtherILBC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031111000348 IL Practitioner - Physical Therapist in Private Practice 1951214386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1920 N Richmond Rd
Suite a
McHenry, IL 60051-5467
Phone (815) 271-6811

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
070-009843ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist CurrentSince Sep 28, 2019 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince May 23, 2018 Accepting new patients
Hispanic Regional Clinics SC Past Accepting new patients

Locations

420 W Northwest Hwy
Ste B
Barrington, IL 60010
Phone (847) 382-3864

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

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

573 W State Route 22
Lake Zurich, IL 60047
Phone (847) 796-3320

1612 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 281-0323

1920 N Richmond Rd
Ste A
McHenry, IL 60051
Phone (815) 271-6811

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

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1871683938",
    "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",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 N RICHMOND RD",
            "address_2": "SUITE A",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600515467",
            "telephone_number": "815-271-6811",
            "fax_number": "815-344-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM SEBASTIAN",
        "first_name": "MERCEDES",
        "middle_name": "E",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-009843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "02232425",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.