Individual provider Active NPI

Shaheen L Behrouz, DPT

  • Physical Therapist
  • Plainfield, IL
National Provider Identifier
1902376155
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-025214 Issued in IL
Practice address
24402 W Lockport St Ste 100
Plainfield, IL 60544-4276
Phone
(815) 609-7000
Fax
(815) 609-7002
NPI assigned
Nov 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 6594 MS
Physical Therapist 225100000X 070-025214 IL Primary

Addresses

Primary practice location

24402 W Lockport St Ste 100
Plainfield, IL 60544-4276

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other practice location 1

7065 Airways Blvd Ste 110
Southaven, MS 38671-5874
Phone (662) 349-8997

Other identifiers 1

IdentifierTypeStateIssuer
6594OtherMSPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201112002520 IL Practitioner - Physical Therapist in Private Practice 5496090011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

24402 W Lockport St
Plainfield, IL 60544-4206
Phone (815) 609-7000

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-025214ILMDPhysical Therapist
6594MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jul 29, 2022 Accepting new patients
Advanced Physicians, S.C. CurrentSince Aug 10, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 29, 2022 Accepting new patients

Locations

16101 Weber Rd
Crest Hill, IL 60403
Phone (815) 306-1100

14330 S Will Cook Rd
Homer Glen, IL 60491
Phone (708) 645-0288

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

24402 W Lockport St
Ste 100
Plainfield, IL 60544
Phone (815) 609-7000

24402 W Lockport St
Plainfield, IL 60544
Phone (815) 239-0395

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

Interoperability endpoints

  • Direct secure messaging: shaheen.behrouz.p9@direct.athleticoltd.nextgenshare.com

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": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1902376155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24402 W LOCKPORT ST STE 100",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605444276",
            "telephone_number": "815-609-7000",
            "fax_number": "815-609-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7065 Airways Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715874",
            "country_code": "US",
            "telephone_number": "662-349-8997",
            "fax_number": "662-349-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEHROUZ",
        "first_name": "SHAHEEN",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-30",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "6594",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-025214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "6594",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.