NPIMap

Organization Active NPI

Select Physical Therapy of Illinois Limited Partnership

  • Physical Therapy Clinic/Center
  • Crystal Lake, IL
National Provider Identifier
1104885136
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SELECT PHYSICAL THERAPY OF ILLINOIS LIMITED PARTNERSHIP
Practice address
820 E Terra Cotta Ave
Ste 102
Crystal Lake, IL 60014
Phone
(815) 455-3262
Fax
(815) 455-2729
NPI assigned
Mar 20, 2006
Reactivated
Jan 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Authorized official

Name
Michael E Tarvin
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X IL Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

820 E Terra Cotta Ave
Ste 102
Crystal Lake, IL 60014

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

National Provider Directory

National Provider Directory

Locations

380 S Schmale Rd
Carol Stream, IL 60188
Phone (630) 462-0101

547 S Schmale Rd
Carol Stream, IL 60188
Phone (630) 462-0101

893 S Randall Rd
Elgin, IL 60123
Phone (847) 742-7772

884 S Rand Rd
Lake Zurich, IL 60047
Phone (847) 726-8456

Practitioners & affiliated clinicians

Practitioners 6

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": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1104885136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100",
            "fax_number": "717-975-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE",
            "address_2": "STE 102",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-455-3262",
            "fax_number": "815-455-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT PHYSICAL THERAPY OF ILLINOIS LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2010-09-01",
        "deactivation_date": "2007-11-20",
        "reactivation_date": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.