Advanced Physical Therapy Services LTD

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ADVANCED PHYSICAL THERAPY SERVICES LTD

Doing business as

Advanced Rehab Sports Medicine

Practice address

256 S Soangetaha Rd Ste 108
Galesburg, IL 61401-5596

Phone

(309) 343-3434

Fax

(309) 343-3456

NPI assigned

Jan 2, 2014

Last updated

Nov 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Steven Oertwig

Title

Director of Finance

Phone

(309) 661-8823

Specialties & licenses 3

Addresses

Other names 1

• Advanced Rehab Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1104247501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617020047",
            "telephone_number": "309-661-8823",
            "fax_number": "309-661-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 S SOANGETAHA RD STE 108",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614015596",
            "telephone_number": "309-343-3434",
            "fax_number": "309-343-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY SERVICES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "OERTWIG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "309-661-8823"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Rehab Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.