AMANDA J BERRY (PT) – Physical Therapist, NPI 1366534877

AMANDA J BERRY (PT) is a healthcare provider. based in Bolingbrook, Illinois. specializing in Physical Therapist. They hold the professional credentials PT. They hold a License No. LPT-033567 (AZ). The NPI Number for AMANDA J BERRY (PT) is 1366534877

Main info

Female
Sole Proprietor
Name
AMANDA J BERRY (PT)
NPI
1366534877
Phone
Not provided
Address
790 REMINGTON BLVD
Enumeration Date
29 September 2006
Last Update Date
25 June 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for AMANDA J BERRY (PT)

  • 790, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604404909

    Phone:

    Type: Mailing

  • 635, Executive Drive, Willowbrook, DuPage County, Illinois, 60527, United States

    WILLOWBROOK, IL 605275603

    Phone: (630) 455-6630

    Fax: (630) 455-6631

    Type: Location

  • 6332 W IRMA LN

    GLENDALE, AZ 853086609

    Phone: (630) 309-0279

    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: 2024-08-16

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
I20240816000872IPhysical Therapist In Private PracticeAZTBD

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

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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 60440)

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Reviews

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Frequently asked questions

Is there an official ID for AMANDA J BERRY (PT) in U.S. healthcare records?
The official identifier for AMANDA J BERRY (PT) is NPI 1366534877.
Is AMANDA J BERRY (PT) still an active registrant?
AMANDA J BERRY (PT) carries an active NPI according to the public dataset.
What expertise is attributed to AMANDA J BERRY (PT)?
AMANDA J BERRY (PT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
Is AMANDA J BERRY (PT) located near Bolingbrook?
AMANDA J BERRY (PT) currently maps to Bolingbrook, Illinois in this extract.
Can I trust this NPI listing for AMANDA J BERRY (PT)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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