Nicholas Interial, PT,DPT,ATC
Individual provider Active NPI Physical Therapist · Moline, IL
NPI 1346617628 · NPPES record last updated Aug 31, 2026
Key facts
- NPI
- 1346617628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070.021600 (IL)
- Practice address
- 510 Valley View Dr
Moline, IL 61265-6133 - Phone
- (309) 797-0866
- Fax
- (309) 278-8831
- NPI assigned
- Aug 21, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rock Valley Physical Therapy Center
Practice addresses (Care Compare)
1225 S Oakwood Ave
Suite 1
Geneseo, IL 61254-1990
Phone (309) 944-6447
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150922001499 | IL | Practitioner - Physical Therapist in Private Practice | 5395052435 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.021600 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Valley Physical Therapy Center | Physical Therapist | Current |
Accepting new patients |
| Rock Valley Physical Therapy Center | Physical Therapist | Current |
Accepting new patients |
| Kewanee Physical Therapy and Rehab Specialists | Physical Therapist | Past |
Accepting new patients |
Locations
1225 S Oakwood Ave
Ste 1
Geneseo, IL 61254
Phone (309) 944-6447
850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070
850 43rd Ave
Ste 300
Moline, IL 61265
Phone (309) 743-0300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.021600 | IL | Yes |
Addresses
Primary practice location
510 Valley View Dr
Moline, IL 61265-6133
Mailing address
5250 Competition Dr Ste 100
Bettendorf, IA 52722-8837
Phone (563) 449-7000
Other practice location 1
985 Avenue Of The Cities Ste 105
Silvis, IL 61282-7001
Phone (309) 865-2663
Other providers in Moline, IL
- Il-Iowa Psychiatry, LLC
- Illinois Liv, LLC
- Illinois Therapy Associates LLC
- Independent Psychiatry SC
- Integrative Wellness Counseling LLC
- Brittney Michelle Ionescu
- Ioan Daniel Ionescu
- Iowa Physicians Clinic Medical Foundation
- Iowa Physicians Clinic Medical Foundation
- Rosendo Islas-Torres
All providers in Moline, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.