NPIMap

Organization Active NPI

Physical Therapy and Sports Injury Rehabilitation

  • Occupational Therapy Assistant
  • Hazel Crest, IL
National Provider Identifier
1154448637
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Legal business name
PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION
Practice address
1816 170TH St
Hazel Crest, IL 60429-1451
Phone
(708) 335-1415
Fax
(708) 335-4792
NPI assigned
Mar 22, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Gregory Walter Kaumeyer, P.T.
Title
Co-Owner
Phone
(708) 335-1415

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

1816 170TH St
Hazel Crest, IL 60429-1451

Mailing address

1816 170TH St
Hazel Crest, IL 60429-1451
Phone (708) 335-1415

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy and Sports Injury Rehabilitation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1154448637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 170TH ST",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291451",
            "telephone_number": "708-335-1415",
            "fax_number": "708-335-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 170TH ST",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291451",
            "telephone_number": "708-335-1415",
            "fax_number": "708-335-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KAUMEYER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "708-335-1415",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.