Individual provider Active NPI

Caryn D Reuland, P.T.

  • Pediatric Physical Therapist
  • Lindenhurst, IL
National Provider Identifier
1033240783
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Practice address
675 Colony Ave
Lindenhurst, IL 60046-7830
Phone
(847) 265-5003
Fax
(847) 265-0536
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X IL Primary

Addresses

Primary practice location

675 Colony Ave
Lindenhurst, IL 60046-7830

Mailing address

675 Colony Ave
Lindenhurst, IL 60046-7830
Phone (847) 265-5003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015000121 IA Practitioner - Physical Therapist in Private Practice 6204234669 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070009715ILMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Oct 8, 2021 Accepting new patients
Genesis Health System CurrentSince Oct 8, 2021 Accepting new patients

Locations

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033240783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 COLONY AVE",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600467830",
            "telephone_number": "847-265-5003",
            "fax_number": "847-265-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 COLONY AVE",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600467830",
            "telephone_number": "847-265-5003",
            "fax_number": "847-265-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REULAND",
        "first_name": "CARYN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.