NPIMap

Organization Active NPI

Sovereign Rehabilitation of Il, LLC

Doing business as Sovereign Pediatric Therapy

  • Physical Therapy Clinic/Center
  • Naperville, IL
National Provider Identifier
1184859241
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SOVEREIGN REHABILITATION OF IL, LLC
Doing business as
Sovereign Pediatric Therapy
Practice address
1315 Macom Dr
Suite 103
Naperville, IL 60564-9358
Phone
(630) 585-7337
Fax
(630) 585-7333
NPI assigned
May 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Authorized official

Name
Joan Lawrence
Title
Director of Operations
Phone
(773) 755-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1315 Macom Dr
Suite 103
Naperville, IL 60564-9358

Mailing address

1315 Macom Dr
Suite 103
Naperville, IL 60564-9358
Phone (630) 585-7337

Other names 1

  • Sovereign Pediatric Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sovereign Rehab of Il LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1184859241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 MACOM DR",
            "address_2": "SUITE 103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649358",
            "telephone_number": "630-585-7337",
            "fax_number": "630-585-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MACOM DR",
            "address_2": "SUITE 103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649358",
            "telephone_number": "630-585-7337",
            "fax_number": "630-585-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN REHABILITATION OF IL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "773-755-7566"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sovereign Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 19, 2009; 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.