Performance Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PERFORMANCE PHYSICAL THERAPY LLC

Practice address

400 Lake St Ste 320B
Roselle, IL 60172

Phone

(630) 550-7368

Fax

(630) 339-0476

NPI assigned

Jun 13, 2018

Organization subpart

No

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

Authorized official

Name

Maulik C Patel, PT

Title

President

Phone

(630) 550-7368

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1386137305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W LAKE ST",
            "address_2": "STE 320-B",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601723573",
            "telephone_number": "630-550-7368",
            "fax_number": "630-339-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKE ST STE 320B",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "60172",
            "telephone_number": "630-550-7368",
            "fax_number": "630-339-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAULIK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-550-7368",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reema C Patel, P.T.
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• George Michael Pellegrino, RPH
• Lauren Rose Pellegrino
• Kathryn Lynn Peters
• Katie J Peterson, PT
• Matthew John Phan, DDS
• Pharma Medical Supply Inc
• Dina Philp

• Physical Therapist in Roselle, IL
• Providers in Roselle, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.