Active NPI
Radha Godambe, PT. DPT
- Physical Therapist
- Bolingbrook, IL
National Provider Identifier
1194051615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.014468
- Practice address
- 726 S Weber Rd Ste 101
Bolingbrook, IL 60490-5416 - Phone
- (800) 974-4378
- Fax
- (630) 515-1536
- NPI assigned
- Oct 19, 2009
- Last updated
- May 12, 2026
- Sex
- Female
- 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 | 070.014468 | IL | Primary |
Addresses
Primary practice location
726 S Weber Rd Ste 101
Bolingbrook, IL 60490-5416
Mailing address
24014 W Renwick Rd Ste 206
Plainfield, IL 60544-8711
Phone (800) 974-4378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
726 S Weber Rd
Suite 101
Bolingbrook, IL 60490-5416
Phone (800) 974-4378
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.014468 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT Holdings PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1194051615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24014 W RENWICK RD STE 206",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605448711",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 S WEBER RD STE 101",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604905416",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODAMBE",
"first_name": "RADHA",
"name_prefix": "Dr.",
"credential": "PT. DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-19",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.014468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.