Organization Active NPI

Harvard Physical Therapy

  • Physical Therapist
  • Harvard, IL
National Provider Identifier
1376688176
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
HARVARD PHYSICAL THERAPY
Practice address
343 S Division St
Harvard, IL 60033-3276
Phone
(815) 943-0191
Fax
(815) 943-0196
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Deborah Gulbrandson, P.T.NPI 1730254202
Title
Owner-President
Phone
(847) 516-8095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X IL Primary

Addresses

Primary practice location

343 S Division St
Harvard, IL 60033-3276

Mailing address

2615 3 Oaks Rd
Suite 1a
Cary, IL 60013-6127
Phone (847) 516-8095

Other identifiers 2

IdentifierTypeStateIssuer
7153220OtherILAETNA
05632091OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

343 S Division St
Harvard, IL 60033
Phone (815) 943-0191

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376688176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 3 OAKS RD",
            "address_2": "SUITE 1A",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600136127",
            "telephone_number": "847-516-8095",
            "fax_number": "847-516-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 S DIVISION ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600333276",
            "telephone_number": "815-943-0191",
            "fax_number": "815-943-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GULBRANDSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "847-516-8095",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7153220",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05632091",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.