Organization Active NPI

Powercare Rehabilitation Corp

  • Physical Therapist
  • Plainfield, IL
National Provider Identifier
1154914638
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
POWERCARE REHABILITATION CORP
Practice address
15507 S Route 59 Ste 4
Plainfield, IL 60544-2723
Phone
(858) 275-3611
Fax
(888) 316-7811
NPI assigned
Feb 16, 2021
Last updated
Feb 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Ellaine De GuzmanNPI 1215367743
Title
Owner of Entity
Phone
(858) 275-3611

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

15507 S Route 59 Ste 4
Plainfield, IL 60544-2723

Mailing address

15507 S Route 59 Ste 4
Plainfield, IL 60544-2723
Phone (858) 275-3611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210217001605 IL Part B Supplier - Clinic/Group Practice 3779998174 Receives reassigned benefits from 5 practitioners
Practice locations: Plainfield, IL

National Provider Directory

National Provider Directory

Locations

15507 S Route 59
Ste 4
Plainfield, IL 60544
Phone (858) 275-3611

15507 S Route 59
Unit 107D
Plainfield, IL 60544
Phone (858) 275-3611

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1154914638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15507 S ROUTE 59 STE 4",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605442723",
            "telephone_number": "858-275-3611",
            "fax_number": "888-316-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15507 S ROUTE 59 STE 4",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605442723",
            "telephone_number": "858-275-3611",
            "fax_number": "888-316-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERCARE REHABILITATION CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "ELLAINE",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "858-275-3611"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.