Organization Active NPI

Affinity Physical Therapy SC Inc

  • Physical Therapy Clinic/Center
  • Libertyville, IL
National Provider Identifier
1437993987
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
AFFINITY PHYSICAL THERAPY SC INC
Practice address
736 Fiorsheim Drive
Suite 13
Libertyville, IL 60048-3704
Phone
(847) 680-1278
Fax
(847) 680-2026
NPI assigned
Jun 20, 2024
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Mr. Ryan A RebmannNPI 1659178556
Title
President
Phone
(847) 680-1278

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

736 Fiorsheim Drive
Suite 13
Libertyville, IL 60048-3704

Mailing address

736 Fiorsheim Drive
Suite 13
Libertyville, IL 60048-3704
Phone (847) 680-1278

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250205001771 IL Part B Supplier - Clinic/Group Practice 9335679489 Receives reassigned benefits from 4 practitioners
Practice locations: Libertyville, IL

National Provider Directory

National Provider Directory

Locations

1117 S Milwaukee Ave
Ste D11
Libertyville, IL 60048
Phone (847) 680-3900

736 Florsheim Dr
Ste 13
Libertyville, IL 60048
Phone (847) 680-1278

Practitioners & affiliated clinicians

Practitioners 5

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": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1437993987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 FIORSHEIM DRIVE",
            "address_2": "SUITE 13",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483704",
            "telephone_number": "847-680-1278",
            "fax_number": "847-680-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 FIORSHEIM DRIVE",
            "address_2": "SUITE 13",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483704",
            "telephone_number": "847-680-1278",
            "fax_number": "847-680-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY PHYSICAL THERAPY SC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "REBMANN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-680-1278",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.