Crystal Lake Physical Therapy Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

070016104 Issued in IL

Legal business name

CRYSTAL LAKE PHYSICAL THERAPY INC

Practice address

735 McArdle Dr Ste a
Crystal Lake, IL 60014-1702

Phone

(815) 893-8480

Fax

(815) 893-8481

NPI assigned

Jan 1, 2016

Organization subpart

No

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

Authorized official

Name

Emily CraigenNPI 1467633636

Title

President/Ceo

Phone

(815) 893-8480

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emily M. Craigen, DPT

  • Physical Therapist
  • Crystal Lake, IL
  • NPI 1467633636
  Medicare reassignment Care Compare group NPD Authorized official
• Becky A Lugardo, DPT

  • Physical Therapist
  • Lake in the Hills, IL
  • NPI 1700316650
  Medicare reassignment Care Compare group NPD
• Sean Mark Labastida Superticioso, PT

  • Physical Therapist
  • Crystal Lake, IL
  • NPI 1497217350
  Medicare reassignment Care Compare group NPD
• Kristine Ann Vukmir, PT, DPT

  • Physical Therapist
  • McHenry, IL
  • NPI 1902323967
  Medicare reassignment Care Compare group NPD
• Kelly Ann Donathan, DPT, ATC

  • Physical Therapist
  • Oakdale, MN
  • NPI 1770879793

  IL

  Medicare reassignment Care Compare group NPD
• Cortney Fowles, PT

  • Physical Therapist
  • Barrington, IL
  • NPI 1386713006
  Medicare reassignment NPD
• Monica Geiser, PT, DPT

  • Physical Therapist
  • Crystal Lake, IL
  • NPI 1497484828
  Medicare reassignment NPD
• Richard M Sebastian II, P.T.

  • Physical Therapist
  • Lincolnshire, IL
  • NPI 1972785350
  Medicare reassignment NPD

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

{
    "created_epoch": "1451606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1326404682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 MCARDLE DR STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141702",
            "telephone_number": "815-893-8480",
            "fax_number": "815-893-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 MCARDLE DR STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141702",
            "telephone_number": "815-893-8480",
            "fax_number": "815-893-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL LAKE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-01",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "CRAIGEN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "815-893-8480"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070016104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Lake Ophthalmology Associates PC
• Crystal Lake Optical Inc.
• Crystal Lake Oral Maxillofacial Surgery LTD
• Crystal Lake Pediatric Dental LTD.
• Crystal Lake Pharmacy Inc
• Crystal Lake Regenerative Pain Associates PLLC
• Crystal Lake Wellness, LLC
• Crystal Pines Rehabilitation and Health Care Center, LLC
• Tiffany Cubbison
• Vanessa Cupp, RN

• Physical Therapy Clinic/Center in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.