Individual provider Active NPI

Matthew Perek, DPT

  • Orthopedic Physical Therapist
  • Hazel Crest, IL
National Provider Identifier
1053074690
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
1816 170TH St
Hazel Crest, IL 60429-1451
Phone
(708) 335-4081
NPI assigned
Oct 20, 2021
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

1816 170TH St
Hazel Crest, IL 60429-1451

Mailing address

1816 170TH St
Hazel Crest, IL 60429-1451
Phone (708) 335-4081

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211130002793 IL Practitioner - Physical Therapist in Private Practice 7416346028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical S CGroup PAC ID 4688562606, 8 clinicians

Practice addresses (Care Compare)

3405 N Arlington Heights Rd
Arlington Heights, IL 60004-1536
Phone (847) 577-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Sep 30, 2023 Accepting new patients
Riverside Medical, S.C. CurrentSince Jan 6, 2025 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Orthopedic CurrentSince Sep 30, 2023 Accepting new patients

Locations

3405 N Arlington Heights Rd
Arlington Heights, IL 60004
Phone (847) 577-9300

3405 N Arlington Heights Rd
#0
Arlington Heights, IL 60004

3405 N Arlington Heights Rd
#R
Arlington Heights, IL 60004
Phone (312) 577-9300

204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225

1816 170th St
Hazel Crest, IL 60429
Phone (708) 335-1415

840 Willow Rd
Ste P
Northbrook, IL 60062
Phone (224) 649-5600

17236 Harlem Ave
Tinley Park, IL 60477
Phone (708) 633-8379

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBGJAA/Endpoint/BBGJAA

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": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1053074690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 170TH ST",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291451",
            "telephone_number": "708-335-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 170TH ST",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291451",
            "telephone_number": "708-335-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREK",
        "first_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.