NPIMap

Organization Active NPI

Kamin Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Park Ridge, IL
National Provider Identifier
1093858862
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KAMIN PHYSICAL THERAPY, INC.
Practice address
770 Busse Hwy
Suite C
Park Ridge, IL 60068-2441
Phone
(847) 384-6804
Fax
(847) 384-6806
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bernadette A. Kamin, MSPTNPI 1144350166
Title
President
Phone
(847) 384-6804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X IL Primary

Addresses

Primary practice location

770 Busse Hwy
Suite C
Park Ridge, IL 60068-2441

Mailing address

770 Busse Hwy
Suite C
Park Ridge, IL 60068-2441
Phone (847) 384-6804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050221000667 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1355393141 Receives reassigned benefits from 7 practitioners
Practice locations: Highland Park, IL; Park Ridge, IL

National Provider Directory

National Provider Directory
Tax ID family
Kamin Physical Therapy3 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.

Locations

828 Busse Hwy
Park Ridge, IL 60068
Phone (847) 384-6804

770 Busse Hwy
Ste C
Park Ridge, IL 60068
Phone (847) 384-6804

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093858862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 BUSSE HWY",
            "address_2": "SUITE C",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682441",
            "telephone_number": "847-384-6804",
            "fax_number": "847-384-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 BUSSE HWY",
            "address_2": "SUITE C",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682441",
            "telephone_number": "847-384-6804",
            "fax_number": "847-384-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMIN PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAMIN",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-384-6804",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.