Supreme Physical Therapy Co.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SUPREME PHYSICAL THERAPY CO.

Practice address

19643 Brookfield Cir
Tinley Park, IL 60487-7087

Phone

(708) 954-7101

NPI assigned

Nov 27, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Alaheldean Abdelhadi, DPTNPI 1265914592

Title

President

Phone

(708) 954-7101

Specialties & licenses 1

Addresses

Other names 1

• Supreme PT Co. Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dianne Frances Quiaoit, PT

  • Physical Therapist
  • La Grange, IL
  • NPI 1598140287
  Medicare reassignment NPD
• Alaheldean Abdelhadi

  • Physical Therapy Assistant
  • Chiago, IL
  • NPI 1265914592
  NPD Authorized official

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1083489611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19643 BROOKFIELD CIR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877087",
            "telephone_number": "708-954-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19643 BROOKFIELD CIR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877087",
            "telephone_number": "708-954-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME PHYSICAL THERAPY CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "ABDELHADI",
        "authorized_official_first_name": "ALAHELDEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-954-7101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supreme PT Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Jian Sun
• Yuhan Sun, DDS
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• Supercare LLC
• Surgical Care Associates LTD
• Nicolette Paige Susralski, MA
• Yogesh G Sutrave, RSA
• Terese Sweeney, RDN, LDN, CEDS-C
• Sweet Dreams Infant Care

• Physical Therapy Clinic/Center in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.