Individual provider Active NPI

Faten Shaabneh, PT

  • Physical Therapist
  • Tinley Park, IL
National Provider Identifier
1902970643
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070012192 Issued in IL
Practice address
16651 Harlem Ave
Tinley Park, IL 60477-2581
Phone
(708) 444-2467
Fax
(708) 444-2758
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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 070012192 IL Primary

Addresses

Primary practice location

16651 Harlem Ave
Tinley Park, IL 60477-2581

Mailing address

6855 Forestview Dr
Oak Forest, IL 60452-1640
Phone (708) 422-4441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081029000393 IL Practitioner - Physical Therapist in Private Practice 0547328908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

2222 Sullivan TRL
Easton, PA 18040-7958

500 McHenry Rd
Buffalo Grove, IL 60089-1705
Phone (847) 537-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070012192ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Mar 11, 2022 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Nov 11, 2024 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Nov 11, 2024 Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Mar 11, 2022 Accepting new patients

Locations

95 Carleton Ave
Glen Ellyn, IL 60137
Phone (630) 233-4056

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 4

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1902970643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6855 FORESTVIEW DR",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521640",
            "telephone_number": "708-422-4441",
            "fax_number": "708-422-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16651 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772581",
            "telephone_number": "708-444-2467",
            "fax_number": "708-444-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAABNEH",
        "first_name": "FATEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; 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.