Elite Rehabilitation Institute Braidwood LLC
Organization Active NPI Chiropractor · Braidwood, IL
NPI 1003105495 · NPPES record last updated Jun 29, 2011
Key facts
- NPI
- 1003105495
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038009041 (IL)
- Legal business name
- ELITE REHABILITATION INSTITUTE BRAIDWOOD LLC
- Practice address
- 180 E Main St
Braidwood, IL 60408-1912 - Phone
- (815) 458-2225
- Fax
- (815) 458-9825
- NPI assigned
- Apr 6, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Anthony M Pirie, D.C.
- Title
- Owner
- Phone
- (815) 458-2225
Practitioners 9
-
Jason P Lamarche, D.C.
-
Rebecca Ann Lamarche, D.C.
-
Anthony M Pirie, D.C.
-
April Crawford, LMT
-
Ryan T. Foster, D.C.
-
Ashley L Gibbons, PT
-
Brian L Schuman, PT
-
Caitlin Rose Sterchi, D.C.
-
John Hugh Braithwaite, D.C., M.S.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110629000683 | IL | Part B Supplier - Clinic/Group Practice | 5395923940 |
Receives reassigned benefits from 3 practitioners Practice locations: Braidwood, IL |
National Provider Directory
Locations
180 E Main St
Braidwood, IL 60408
Phone (815) 458-2225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 038009041 | IL | Yes |
| Physical Therapist |
225100000X | 070013955 | IL |
Addresses
Primary practice location
180 E Main St
Braidwood, IL 60408-1912
Mailing address
180 E Main St
Braidwood, IL 60408-1912
Phone (815) 458-2225
Other providers in Braidwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.