Organization Active NPI

Ewima Rehab, LLC

  • Chiropractor
  • Northbrook, IL
National Provider Identifier
1396586038
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EWIMA REHAB, LLC
Practice address
3400 Dundee Rd Ste 230
Northbrook, IL 60062-2334
Phone
(847) 849-1523
Fax
(847) 890-6145
NPI assigned
Jun 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Helen Riveron Cruz
Title
Practice Manager
Phone
(773) 618-2378

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

3400 Dundee Rd Ste 230
Northbrook, IL 60062-2334

Mailing address

3400 Dundee Rd Ste 230
Northbrook, IL 60062-2334
Phone (847) 849-1523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240827000889 IL Part B Supplier - Clinic/Group Practice 0749729481 Receives reassigned benefits from 2 practitioners
Practice locations: Northbrook, IL

National Provider Directory

National Provider Directory

Locations

3400 Dundee Rd
Ste 230
Northbrook, IL 60062
Phone (847) 226-5503

3400 Dundee Rd
Northbrook, IL 60062
Phone (312) 492-4820

Practitioners & affiliated clinicians

Practitioners 2

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": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1396586038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DUNDEE RD STE 230",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622334",
            "telephone_number": "847-849-1523",
            "fax_number": "847-890-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DUNDEE RD STE 230",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622334",
            "telephone_number": "847-849-1523",
            "fax_number": "847-890-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EWIMA REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "RIVERON CRUZ",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "773-618-2378"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.