NPIMap

Organization Active NPI

Midwest Sports Medicine & Orthopedic Surgical Specialists, LTD

  • Physical Therapist
  • Roselle, IL
National Provider Identifier
1255548798
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MIDWEST SPORTS MEDICINE & ORTHOPEDIC SURGICAL SPECIALISTS, LTD
Practice address
975 E Nerge Rd
Suite N140
Roselle, IL 60172-4804
Phone
(847) 944-1230
Fax
(847) 944-1240
NPI assigned
May 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rosemary A Martin
Title
Director
Phone
(847) 437-9889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

975 E Nerge Rd
Suite N140
Roselle, IL 60172-4804

Mailing address

975 E Nerge Rd
Suite N140
Roselle, IL 60172-4804
Phone (847) 944-1230

Other identifiers 1

IdentifierTypeStateIssuer
31603457OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • The Center for Physical Therapy Other name

National Provider Directory

National Provider Directory
Tax ID family
Midwest Sports Med Orthopa9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

975 E Nerge Rd
Ste N140
Roselle, IL 60172
Phone (847) 944-1230

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255548798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E NERGE RD",
            "address_2": "SUITE N140",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601724804",
            "telephone_number": "847-944-1230",
            "fax_number": "847-944-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E NERGE RD",
            "address_2": "SUITE N140",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601724804",
            "telephone_number": "847-944-1230",
            "fax_number": "847-944-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST SPORTS MEDICINE & ORTHOPEDIC SURGICAL SPECIALISTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-437-9889"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31603457",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roselle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.