NPIMap

Organization Active NPI

Sovereign Rehab

  • Clinic/Center
  • Naperville, IL
National Provider Identifier
1093114498
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
070001782 Issued in IL
Legal business name
SOVEREIGN REHAB
Practice address
1315 Macom Dr. Suite 103
Naperville, IL 60564
Phone
(630) 585-7337
NPI assigned
Aug 21, 2014
Last updated
Aug 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Mr. Rick Rausch, PT
Title
President
Phone
(630) 585-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 070001782 IL Primary

Addresses

Primary practice location

1315 Macom Dr. Suite 103
Naperville, IL 60564

Mailing address

1315 Macom Dr Ste 103
Naperville, IL 60564-9360
Phone (630) 585-7337

National Provider Directory

National Provider Directory
Tax ID family
Sovereign Rehabilitation of Il LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1093114498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 MACOM DR STE 103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649360",
            "telephone_number": "630-585-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MACOM DR. SUITE 103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60564",
            "telephone_number": "630-585-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "RAUSCH",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-585-7337",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "070001782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.