Individual provider Active NPI

Joven Christopher Taguinod Cerdenia, PT

  • Physical Therapist
  • Glenview, IL
National Provider Identifier
1326177767
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070015277 Issued in IL
Practice address
2301 Willow Rd Ste L
Glenview, IL 60025-7637
Phone
(630) 933-1500
Fax
(630) 933-1550
NPI assigned
Mar 2, 2007
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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 070015277 IL Primary

Addresses

Primary practice location

2301 Willow Rd Ste L
Glenview, IL 60025-7637

Mailing address

2301 Willow Rd Ste L
Glenview, IL 60025-7637
Phone (630) 933-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724003073 IL Practitioner - Physical Therapist in Private Practice 4385180512

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2301 Willow Rd
Suite L
Glenview, IL 60025-7637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070015277ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 12, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 12, 2024 Accepting new patients
Central Dupage Physician Group PastSince Aug 18, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2301 Willow Rd
Unit L
Glenview, IL 60025

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1326177767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 WILLOW RD STE L",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257637",
            "telephone_number": "630-933-1500",
            "fax_number": "630-933-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 WILLOW RD STE L",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257637",
            "telephone_number": "630-933-1500",
            "fax_number": "630-933-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERDENIA",
        "first_name": "JOVEN CHRISTOPHER",
        "middle_name": "TAGUINOD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.