MRS. JONELLA RENEE BLACK (PT) – Neurology Physical Therapist, NPI 1215252036

MRS. JONELLA RENEE BLACK (PT) is a healthcare provider. based in Evanston, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 070005649 (IL). The NPI Number for MRS. JONELLA RENEE BLACK (PT) is 1215252036

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JONELLA RENEE BLACK (PT)
NPI
1215252036
Phone
(847) 570-1260
Address
1000 CENTRAL ST
Enumeration Date
5 April 2010
Last Update Date
5 April 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8472680280
Graduation Year
1996 (30 years ago)
PAC ID
0446608079
Group Practice PAC ID
3375430499
Professional Enrollment ID
I20240104004471
Address ID
IL600683271PA444XXHWYX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

5,030 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

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Provider Addresses for MRS. JONELLA RENEE BLACK (PT)

  • 1000, Central Street, Evanston, Evanston Township, Cook County, Illinois, 60201, United States

    SUITE 101

    EVANSTON, IL 602011777

    Phone: (847) 570-1260

    Type: Location

  • 1503, Madison Street, Evanston, Evanston Township, Cook County, Illinois, 60202, United States

    EVANSTON, IL 60202

    Phone: (847) 864-5740

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240104004471IPhysical Therapist In Private PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375430499View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

What is the registry number for MRS. JONELLA RENEE BLACK (PT)?
The registry entry for MRS. JONELLA RENEE BLACK (PT) shows NPI 1215252036.
Is MRS. JONELLA RENEE BLACK (PT) currently accepting referrals based on NPI status?
Registry metadata lists MRS. JONELLA RENEE BLACK (PT) as active.
Which specialty label fits MRS. JONELLA RENEE BLACK (PT)?
NPPES ties MRS. JONELLA RENEE BLACK (PT) to Neurology Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is MRS. JONELLA RENEE BLACK (PT) tied to Evanston, Illinois?
If you are local to Evanston, Illinois, MRS. JONELLA RENEE BLACK (PT) may be relevant to your search.
Why is information missing for MRS. JONELLA RENEE BLACK (PT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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