Pentafil Physical Therapy Service

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

PENTAFIL PHYSICAL THERAPY SERVICE

Practice address

790 Royal Saint George Dr
Suite 105
Naperville, IL 60563-8955

Phone

(630) 527-6370

Fax

(630) 527-6374

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Miss Olymphia Roldan Tesoro, P.T.

Title

President

Phone

(630) 527-6370

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1346368347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 ROYAL SAINT GEORGE DR",
            "address_2": "SUITE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638955",
            "telephone_number": "630-527-6370",
            "fax_number": "630-527-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 ROYAL SAINT GEORGE DR",
            "address_2": "SUITE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638955",
            "telephone_number": "630-527-6370",
            "fax_number": "630-527-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENTAFIL PHYSICAL THERAPY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "TESORO",
        "authorized_official_first_name": "OLYMPHIA",
        "authorized_official_middle_name": "ROLDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-527-6370",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2215734",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa C Pellegrini, M.D.
• Roberto Pena Jr., LCSW, CADC
• Pendle Consulting LLC
• Renata Pendle, BCBA, LBA
• Kun Peng, MD
• Pentafil Physical Therapy Services
• Laura Ann Pepper, LSW CADC
• Per la Vita Wellness PLLC
• James R Pera, MD
• Sandra Perez Avila, LSW

• Rehabilitation Clinic/Center in Naperville, IL
• Providers in Naperville, IL by specialty
• Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.