Individual provider Active NPI

Gina Stoll

  • Physical Therapist
  • Libertyville, IL
National Provider Identifier
1942072723
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.027872 Issued in IL
Practice address
1757 Northwind Blvd
Libertyville, IL 60048-9617
Phone
(224) 206-0200
Fax
(224) 206-0201
NPI assigned
Oct 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 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 070.027872 IL Primary

Addresses

Primary practice location

1757 Northwind Blvd
Libertyville, IL 60048-9617

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131001926 IL Practitioner - Physical Therapist in Private Practice 7810340338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Rehabilitation Services LLCGroup PAC ID 2264479518, 569 clinicians

Practice addresses (Care Compare)

1757 Northwind Blvd
Libertyville, IL 60048-9617
Phone (586) 350-2644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.027872ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Dec 18, 2023 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Dec 18, 2023 Accepting new patients

Locations

3973 W Algonquin Rd
Algonquin, IL 60102
Phone (224) 348-7600

27401 W Il Route 22
Ste 111
Barrington, IL 60010
Phone (224) 427-3330

10801 S Western Ave
Chicago, IL 60643
Phone (773) 445-4200

1757 Northwind Blvd
Libertyville, IL 60048
Phone (224) 206-0200

9 N 2nd St
St Charles, IL 60174
Phone (630) 526-4200

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

Organizations & group practices 2

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": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1942072723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 NORTHWIND BLVD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489617",
            "telephone_number": "224-206-0200",
            "fax_number": "224-206-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLL",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.027872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.