Active NPI
Ryan Stover, PT, MPT, CSCS
- Physical Therapist
- Buffalo Grove, IL
National Provider Identifier
1184819815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1555 Barclay Blvd
Buffalo Grove, IL 60089-4518 - Phone
- (708) 671-0771
- Fax
- (708) 671-0771
- NPI assigned
- Sep 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Primary |
Addresses
Primary practice location
1555 Barclay Blvd
Buffalo Grove, IL 60089-4518
Mailing address
12400 S Harlem Ave
Palos Heights, IL 60463
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7454077 | Other | AETNA | |
| 01622333 | Other | BLUE CROSS BLUE SHIELD ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070013037 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WCS Occupational Rehabilitation and Sports Medicine, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Buffalo Grove, IL
- NPI 1366599383
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1184819815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12400 S HARLEM AVE",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "60463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 BARCLAY BLVD",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600894518",
"telephone_number": "708-671-0771",
"fax_number": "708-671-0771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVER",
"first_name": "RYAN",
"credential": "PT, MPT, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-06",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7454077",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD ID",
"identifier": "01622333",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo Grove, IL
- Katherine Elizabeth Stevens, PH.D.
- Scott Stolarick, LCPC
- Alex Zachary Stoller, MS, RDN
- Kelly Stone, AT
- Jennifer Stotlar, ND, CNS, LDN
- Alex Striltschuk, DDS
- Thomas Morgan Sullivan, ATC
- Sunrise Buffalo Gove Assisted Living, LL (Sunrise of Buffalo Grove)
- Superior Dental, LTD. (dba Countryside Dental Ltd.)
- Ryan Swanson, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.