Illinois Back Institute is a medicare enrolled "Family Medicine - Sports Medicine" provider in Orland Park, Illinois. Their current practice location is
11540 183rd Pl Unit A, Orland Park, Illinois. You can reach out to their office (for appointments etc.) via phone at
(630) 677-3742.
Illinois Back Institute is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Illinois Back Institute
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1750985214.
Healthcare Provider's Profile
| Full Name | Illinois Back Institute |
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| Type | Facility |
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| Speciality | Family Medicine - Sports Medicine |
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| Location | 11540 183rd Pl Unit A, Orland Park, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1750985214
- Provider Enumeration Date: 11/25/2020
- Last Update Date: 03/12/2021
Medicare PECOS Information:
- PECOS PAC ID: 3072926385
- Enrollment ID: O20210106000205
Medical Identifiers
Medical identifiers for Illinois Back Institute such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1750985214 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Illinois Back Institute acts as a billing entity for following providers:
| Provider Name | Kristin K Walsh |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1770537409
PECOS PAC ID: 3678517398
Enrollment ID: I20050614000710 |
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| Provider Name | Lyubov Shapiro |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1356572697
PECOS PAC ID: 5597803841
Enrollment ID: I20091106000513 |
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| Provider Name | James A Joseph |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1083660229
PECOS PAC ID: 6800089988
Enrollment ID: I20101021000428 |
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| Provider Name | Allison K Shewmake |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1669047460
PECOS PAC ID: 1052713237
Enrollment ID: I20210709002533 |
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| Provider Name | Suling Li |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1437798436
PECOS PAC ID: 5799174090
Enrollment ID: I20211108000681 |
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| Provider Name | Summer Jackson |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1790432458
PECOS PAC ID: 1850769597
Enrollment ID: I20221130001208 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Illinois Back Institute is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Illinois Back Institute
11540 183rd Pl Unit A,
Orland Park, IL 60467-9496
Ph: () - | Illinois Back Institute
11540 183rd Pl Unit A,
Orland Park, IL 60467-9496
Ph: (630) 677-3742 |
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