NPIMap

Organization Active NPI

Community Therapy Corp

  • Speech-Language Pathologist
  • St Charles, IL
National Provider Identifier
1336609684
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
COMMUNITY THERAPY CORP
Practice address
525 Tyler Rd Ste Q1
St Charles, IL 60174-3360
Phone
(630) 444-0077
Fax
(630) 444-0078
NPI assigned
Mar 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Authorized official

Name
Dr. Angel Gray, PHD
Title
President
Phone
(630) 444-0077

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

525 Tyler Rd Ste Q1
St Charles, IL 60174-3360

Mailing address

333 W Irving Park Rd Ste 206
Roselle, IL 60172-1134
Phone (312) 952-0321

Other practice location 1

333 W Irving Park Rd Ste 206
Roselle, IL 60172-1134
Phone (630) 893-7995

Other names 1

  • Community Therapy Services Doing business as

National Provider Directory

National Provider Directory

Locations

333 W Irving Park Rd
Ste 206
Roselle, IL 60172
Phone (630) 893-7995

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1336609684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W IRVING PARK RD STE 206",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601721134",
            "telephone_number": "312-952-0321",
            "fax_number": "630-444-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TYLER RD STE Q1",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601743360",
            "telephone_number": "630-444-0077",
            "fax_number": "630-444-0078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 W Irving Park Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Roselle",
            "state": "IL",
            "postal_code": "601721134",
            "country_code": "US",
            "telephone_number": "630-893-7995",
            "fax_number": "630-444-0078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-444-0077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.