In-Home Physical Therapy and Wellness, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

IN-HOME PHYSICAL THERAPY AND WELLNESS, LLC

Practice address

7 Millbrook CT
Algonquin, IL 60102-2542

Phone

(217) 653-6814

Fax

(877) 482-0929

NPI assigned

Nov 1, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Michael Gamboa Rivera, PT

Title

Physical Therapist

Phone

(217) 653-6814

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1366728560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MILLBROOK CT",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601022542",
            "telephone_number": "217-653-6814",
            "fax_number": "877-482-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MILLBROOK CT",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601022542",
            "telephone_number": "217-653-6814",
            "fax_number": "877-482-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN-HOME PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GAMBOA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "12176536814",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL6887",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Algonquin, IL
• Providers in Algonquin, 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 Sep 18, 2012; 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.