Active NPI
Reny A Samuel, PT
- Physical Therapist
- Joliet, IL
National Provider Identifier
1346563343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070011726
- Practice address
- 101 N 129TH Infantry Dr
Joliet, IL 60435-5135 - Phone
- (815) 730-6800
- NPI assigned
- Mar 4, 2010
- Sex
- Female
- 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 | 070011726 | IL | Primary |
Addresses
Primary practice location
101 N 129TH Infantry Dr
Joliet, IL 60435-5135
Mailing address
101 N 129TH Infantry Dr
Joliet, IL 60435-5135
Phone (815) 730-6800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070011726 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1346563343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 N 129TH INFANTRY DR",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355135",
"telephone_number": "815-730-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N 129TH INFANTRY DR",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355135",
"telephone_number": "815-730-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "RENY",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-04",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070011726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.