Individual provider Active NPI

Rafael Victor S De Veyra, PT

  • Physical Therapist
  • Skokie, IL
National Provider Identifier
1023726668
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014035 Issued in IL
Practice address
9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703
Phone
(847) 983-8841
Fax
(888) 401-3644
NPI assigned
Nov 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 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 070014035 IL Primary

Addresses

Primary practice location

9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703

Mailing address

1708 Lunt Ave
Des Plaines, IL 60018-3839
Phone (773) 733-8577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230913000602 IL Practitioner - Physical Therapist in Private Practice 4486018207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Maxx LLCGroup PAC ID 3072842590, 14 clinicians

Practice addresses (Care Compare)

1530 N Randall Rd
Suite 222
Elgin, IL 60123-7879
Phone (847) 258-5420

8933 W Golf Rd
Niles, IL 60714-5812
Phone (847) 258-5420

916 E Northwest Hwy
Palatine, IL 60074-6506
Phone (847) 258-5420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dependable Care Staffing, LLC Physical Therapist CurrentSince May 16, 2023 Accepting new patients
Rehab Maxx LLC Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

415 W Golf Rd
Ste 52
Arlington Hts, IL 60005
Phone (847) 258-5420

1530 N Randall Rd
Elgin, IL 60123
Phone (224) 760-7322

9933 Lawler Ave
Ste 206B
Skokie, IL 60077
Phone (847) 983-8417

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": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1023726668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 LUNT AVE",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600183839",
            "telephone_number": "773-733-8577",
            "fax_number": "888-401-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 206B",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-983-8841",
            "fax_number": "888-401-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VEYRA",
        "first_name": "RAFAEL VICTOR",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.