Individual provider Active NPI

Marvin Galido Ventura, PT

  • Physical Therapist
  • Northbrook, IL
National Provider Identifier
1215077615
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
70014698 Issued in IL
Practice address
755 Skokie Blvd
Northbrook, IL 60062-2805
Phone
(847) 272-7426
Fax
(847) 412-6440
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 70014698 IL Primary

Addresses

Primary practice location

755 Skokie Blvd
Northbrook, IL 60062-2805

Mailing address

1521 Johnson Dr Apt 813
Buffalo Grove, IL 60089-6980
Phone (847) 272-7426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105002469 IL Practitioner - Physical Therapist in Private Practice 4587154851 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Luna Care Physical Therapy LLCGroup PAC ID 5193153450, 129 clinicians
KG Therapy PLLCGroup PAC ID 1951764158, 3 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Naperville, IL 60563
Phone (866) 525-3175

1131 McHenry Rd
Suite 107
Buffalo Grove, IL 60089-1369
Phone (847) 305-1097

14595 W Rockland Rd
Libertyville, IL 60048-9700
Phone (224) 433-6480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70014698ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
KG Therapy PLLC Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients

Locations

1131 McHenry Rd
#107
Buffalo Grove, IL 60089
Phone (847) 305-1097

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215077615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 JOHNSON DR APT 813",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896980",
            "telephone_number": "847-272-7426",
            "fax_number": "847-412-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622805",
            "telephone_number": "847-272-7426",
            "fax_number": "847-412-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "MARVIN",
        "middle_name": "GALIDO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70014698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.