Carla Mae Haverland, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070014865 Issued in IL

Practice address

2655 W Peterson Ave
Chicago, IL 60659-4017

Phone

(773) 942-6528

NPI assigned

Apr 23, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carla Mae Reroma Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Engram

  • Physical Therapist
  • Chicago, IL
  • NPI 1295404820
  Medicare reassignment NPD Authorized official
• B&a Health Provider LLC

  • Family Medicine Physician
  • Darien, IL
  • NPI 1699377200
  Medicare reassignment NPD

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1184899072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594017",
            "telephone_number": "773-942-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERLAND",
        "first_name": "CARLA MAE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA MAE",
            "last_name": "REROMA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathon Glen Neumann Haven, MS, BCBA
• Barbara V Havens
• Kirsten Havens, APRN
• Michael Andrew Havens, M.D.
• Karen Susan Haverkamp, MD
• Sara Elizabeth Haverty, DPT
• Mikaela Elisabeth Havey
• Robert J Havey, MD
• Nicole Havlik, MS, RDN, LDN
• Dorota K Havlin

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.