NPIMap

Organization Active NPI

Action Physical Medicine & Rehabilitation, SC

  • Physical Medicine & Rehabilitation Physician
  • Shorewood, IL
National Provider Identifier
1174593016
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ACTION PHYSICAL MEDICINE & REHABILITATION, SC
Practice address
850 Brook Forest Ave
Unit F
Shorewood, IL 60404-8513
Phone
(815) 725-4918
Fax
(815) 725-4955
NPI assigned
Jan 24, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
John Mikuzis, D.O.NPI 1629048178
Title
Owner
Phone
(815) 725-4918

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

850 Brook Forest Ave
Unit F
Shorewood, IL 60404-8513

Mailing address

850 Brook Forest Ave
Unit F
Shorewood, IL 60404-8513
Phone (815) 725-4918

National Provider Directory

National Provider Directory

Locations

1315 Macom Dr
Ste 5
Naperville, IL 60564
Phone (630) 904-5640

2156 Deep Water Ln
Naperville, IL 60564
Phone (630) 904-0700

1890 Silver Cross Blvd
Ste 42
New Lenox, IL 60451

Practitioners & affiliated clinicians

Practitioners 11

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": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1174593016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BROOK FOREST AVE",
            "address_2": "UNIT F",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048513",
            "telephone_number": "815-725-4918",
            "fax_number": "815-725-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BROOK FOREST AVE",
            "address_2": "UNIT F",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048513",
            "telephone_number": "815-725-4918",
            "fax_number": "815-725-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTION PHYSICAL MEDICINE & REHABILITATION, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MIKUZIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-725-4918",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.