NPIMap

Organization Active NPI

Dupage Health and Physical Therapy Center SC

  • Clinic/Center
  • Naperville, IL
National Provider Identifier
1164586798
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
042-618902 Issued in IL
Legal business name
DUPAGE HEALTH AND PHYSICAL THERAPY CENTER SC
Practice address
1795 S Washington St Ste 109
Naperville, IL 60565-2058
Phone
(331) 401-5900
Fax
(331) 215-7318
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Dr. Richard R. Fay, DCNPI 1669570677
Title
Owner
Phone
(331) 401-5900

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
Clinic/Center 261Q00000X 042-618902 IL Primary

Addresses

Primary practice location

1795 S Washington St Ste 109
Naperville, IL 60565-2058

Mailing address

1795 S Washington St Ste 109
Naperville, IL 60565-2058
Phone (630) 961-0259

Other identifiers 1

IdentifierTypeStateIssuer
02232874OtherILBLUE CROSSBLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070314000209 IL Part B Supplier - Clinic/Group Practice 6800999798 Receives reassigned benefits from 2 practitioners
Practice locations: Naperville, IL

National Provider Directory

National Provider Directory

Locations

1795 S Washington St
Ste 109
Naperville, IL 60565
Phone (331) 401-5900

Practitioners & affiliated clinicians

Practitioners 10

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": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1164586798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 S WASHINGTON ST STE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605652058",
            "telephone_number": "630-961-0259",
            "fax_number": "630-961-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 S WASHINGTON ST STE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605652058",
            "telephone_number": "331-401-5900",
            "fax_number": "331-215-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE HEALTH AND PHYSICAL THERAPY CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "FAY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "331-401-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "042-618902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSSBLUE SHIELD",
            "identifier": "02232874",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.