Organization Active NPI

Sage Rehabilitation Inc

  • Speech-Language Pathologist
  • Joliet, IL
National Provider Identifier
1376655092
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SAGE REHABILITATION INC
Practice address
2814 Stacia CT
Joliet, IL 60431-9218
Phone
(815) 690-2100
Fax
(815) 254-8267
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kushalraj Pukhraj, MS
Title
President
Phone
(815) 690-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X IL Primary

Addresses

Primary practice location

2814 Stacia CT
Joliet, IL 60431-9218

Mailing address

2814 Stacia CT
Joliet, IL 60431-9218
Phone (815) 690-2100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376655092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 STACIA CT",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604319218",
            "telephone_number": "815-690-2100",
            "fax_number": "815-254-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 STACIA CT",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604319218",
            "telephone_number": "815-690-2100",
            "fax_number": "815-254-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PUKHRAJ",
        "authorized_official_first_name": "KUSHALRAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-690-2100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "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 Aug 22, 2020; 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.