Bravehearts at the Bergmann Center
Organization Active NPI Physical Therapist · Poplar Grove, IL
NPI 1497060743 · NPPES record last updated Aug 11, 2010
Key facts
- NPI
- 1497060743
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070008709 (IL)
- Legal business name
- BRAVEHEARTS AT THE BERGMANN CENTER
- Practice address
- 4950 Il Route 173
Poplar Grove, IL 61065-9718 - Phone
- (815) 765-2113
- Fax
- (815) 943-8426
- NPI assigned
- Aug 11, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Rolf M. Gunnar, M.D.
- Title
- Chairman of the Board of Directors
- Phone
- (708) 485-5629
Practitioners 19
-
Kelly Brooke Dinsmore, M.S., CCC-SLP/L
-
Monica D Griffin, OTD, OTR/L, C/NDT
-
Jamie Jo Janssen Strait, PSYD
-
Ashley Kara Kohanyi, LSW
-
Kelly Zane Maffei, M.S.
-
Ashley Lynn Moritz, M.S., CCC-SLP/L
-
Rachel Pawlowski, OTR/L
-
Kaleena C Tolsma, SLP
-
Christa Kokott, OT
National Provider Directory
Locations
4950 Il Route 173
Poplar Grove, IL 61065
Phone (815) 703-7043
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 070008709 | IL | Yes |
| Occupational Therapist |
225X00000X | 056004082 | IL | |
| Speech-Language Pathologist |
235Z00000X | 146004807 | IL |
Addresses
Primary practice location
4950 Il Route 173
Poplar Grove, IL 61065-9718
Mailing address
4950 Il Route 173
Poplar Grove, IL 61065-9718
Phone (815) 765-2113
Other names
- BraveHearts Therapeutic Riding and Education Center
Other providers in Poplar Grove, IL
- Jessica Ballard
- Baylee Baumann
- Mary S Bays
- William M Bitsas
- Kathy Blackmer
- Jeffry Stephen Clow
- Patricia J. Cox
- Mark Currier
- Troy Michael Doetch
- Felker Pharmacy Inc
All providers in Poplar Grove, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.