Organization Active NPI

Iron Mind Rehab and Performance LLC

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1174374235
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
IRON MIND REHAB AND PERFORMANCE LLC
Practice address
2861 N Clybourn Ave
Chicago, IL 60618-8201
Phone
(314) 698-7594
NPI assigned
Mar 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Rebecca Ward, DPT
Title
Owner, Physical Therapist
Phone
(314) 698-7594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2861 N Clybourn Ave
Chicago, IL 60618-8201

Mailing address

1712 W Wilson Ave Apt 3E
Chicago, IL 60640-4540
Phone (314) 698-7594

National Provider Directory

National Provider Directory

Locations

2861 N Clybourn Ave
Chicago, IL 60618
Phone (314) 698-7594

Practitioners & affiliated clinicians

Practitioners 1

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": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1174374235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 W WILSON AVE APT 3E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404540",
            "telephone_number": "314-698-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606188201",
            "telephone_number": "314-698-7594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRON MIND REHAB AND PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "314-698-7594",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.