Active NPI
David Rivera
- Physical Therapist
- Forest Park, IL
National Provider Identifier
1265732010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070014053
- Practice address
- 800 Desplaines Ave
Forest Park, IL 60130-2035 - Phone
- (708) 366-2442
- NPI assigned
- Oct 27, 2010
- Sex
- Male
- 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 | 070014053 | IL | Primary |
Addresses
Primary practice location
800 Desplaines Ave
Forest Park, IL 60130-2035
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120606000529 | IL | Practitioner - Physical Therapist in Private Practice | 4183888951 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1105 W Park Ave
Suite 5
Libertyville, IL 60048-2567
Phone (847) 996-6964
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070014053 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cura Physical Therapy & Sports Medicine LLC | Physical Therapist | Current | Accepting new patients |
Locations
1105 W Park Ave
Ste 5
Libertyville, IL 60048
Phone (847) 894-4118
Organizations & group practices 1
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.
-
- Physical Therapist
- Libertyville, IL
- NPI 1679306062
IL, Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1265732010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 DESPLAINES AVE",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601302035",
"telephone_number": "708-366-2442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-27",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070014053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.