NPIMap

Organization Active NPI

Physical Therapy and Sports Injury Rehabilitation

  • Athletic Trainer
  • Blue Island, IL
National Provider Identifier
1194842708
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION
Practice address
13114 Western Ave
Blue Island, IL 60406-2439
Phone
(708) 824-0515
Fax
(708) 824-0517
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Gregory Walter Kaumeyer, P.T.
Title
Co-Owner
Phone
(708) 335-1415

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

13114 Western Ave
Blue Island, IL 60406-2439

Mailing address

13114 Western Ave
Blue Island, IL 60406-2439
Phone (708) 824-0515

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy and Sports Injury Rehabilitation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1194842708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13114 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062439",
            "telephone_number": "708-824-0515",
            "fax_number": "708-824-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13114 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062439",
            "telephone_number": "708-824-0515",
            "fax_number": "708-824-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KAUMEYER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "708-335-1415",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.