Individual provider Active NPI

Raymond Douglas Letke, PT

  • Physical Therapist
  • Orland Park, IL
National Provider Identifier
1245341296
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070013072 Issued in IL
Practice address
14700 S la Grange Rd
Unit a
Orland Park, IL 60462-3248
Phone
(708) 873-8822
Fax
(708) 873-8823
NPI assigned
Aug 31, 2006
Last updated
Nov 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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 070013072 IL Primary

Addresses

Primary practice location

14700 S la Grange Rd
Unit a
Orland Park, IL 60462-3248

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161122002365 IL Practitioner - Physical Therapist in Private Practice 7416236070 Reassigns benefits to 1 organization
I20250414000384 IN Practitioner - Physical Therapist in Private Practice 7416236070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Therapy LLCGroup PAC ID 6709213242, 2 clinicians

Practice addresses (Care Compare)

11055 Broadway
Suite a
Crown Point, IN 46307-7300
Phone (219) 797-7463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Sep 30, 2023 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Sep 30, 2023 Accepting new patients

Locations

204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225

1816 170th St
Hazel Crest, IL 60429
Phone (708) 335-1415

840 Willow Rd
Ste P
Northbrook, IL 60062
Phone (224) 649-5600

17236 Harlem Ave
Tinley Park, IL 60477
Phone (708) 633-8379

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, 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1245341296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 S LA GRANGE RD",
            "address_2": "UNIT A",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623248",
            "telephone_number": "708-873-8822",
            "fax_number": "708-873-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETKE",
        "first_name": "RAYMOND",
        "middle_name": "DOUGLAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.