NPIMap

Organization Active NPI

Sovereign Rehabilitation of Illinois LLC

Doing business as Sovereign Rehabilitation

  • Physical Therapy Clinic/Center
  • Chicago, IL
National Provider Identifier
1376786749
Registry record updated May 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
070001827 Issued in IL
Legal business name
SOVEREIGN REHABILITATION OF ILLINOIS LLC
Doing business as
Sovereign Rehabilitation
Practice address
2835 N Sheffield Ave
Suite 401
Chicago, IL 60657-5081
Phone
(773) 755-7566
Fax
(773) 755-7580
NPI assigned
Apr 14, 2009
Organization subpart
Yes
Parent organization
SOVEREIGN REHABILITATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2009

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

Authorized official

Name
Richard W Rausch, PT
Title
President
Phone
(773) 755-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 070001827 IL Primary

Addresses

Primary practice location

2835 N Sheffield Ave
Suite 401
Chicago, IL 60657-5081

Mailing address

2835 N Sheffield Ave
Suite 401
Chicago, IL 60657-5081
Phone (773) 755-7566

Other names 1

  • Sovereign Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Part of
Sovereign Rehab of Il LLC

Locations

2835 N Sheffield Ave
Ste 40
Chicago, IL 60657
Phone (773) 755-7566

Practitioners & affiliated clinicians

Practitioners 4

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": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1376786749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE",
            "address_2": "SUITE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575081",
            "telephone_number": "773-755-7566",
            "fax_number": "773-755-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE",
            "address_2": "SUITE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575081",
            "telephone_number": "773-755-7566",
            "fax_number": "773-755-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN REHABILITATION OF ILLINOIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOVEREIGN REHABILITATION",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "RAUSCH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-755-7566",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070001827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sovereign Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; 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.