NPIMap

Organization Active NPI

Easter Seals Dupage and the Fox Valley Region

  • Physical Therapist
  • Villa Park, IL
National Provider Identifier
1568460681
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EASTER SEALS DUPAGE AND THE FOX VALLEY REGION
Practice address
830 S. Addison Avenue
Villa Park, IL 60181
Phone
(630) 620-4433
Fax
(630) 620-1148
NPI assigned
Jul 12, 2005
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Theresa Forthofer
Title
President/Ceo
Phone
(630) 620-4433

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X
Social Worker 104100000X
Clinical Social Worker 1041C0700X
Nutritionist 133N00000X
Registered Dietitian 133V00000X
Developmental - Behavioral Pediatrics Physician 2080P0006X
Physical Medicine & Rehabilitation Physician 208100000X
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X
Audiologist 231H00000X
Speech-Language Pathologist 235Z00000X
Augmentative Communication Clinic/Center 261QA3000X
Developmental Disabilities Clinic/Center 261QD1600X
Durable Medical Equipment & Medical Supplies 332B00000X
Developmental Therapist 222Q00000X

Addresses

Primary practice location

830 S. Addison Avenue
Villa Park, IL 60181

Mailing address

830 S. Addison Avenue
Villa Park, IL 60181-2877
Phone (630) 620-4433

Other practice location 1

1135 Bowes Rd Ste B
Elgin, IL 60123-5541
Phone (847) 742-3264

Other practice location 2

1555 Bond St Ste 115
Naperville, IL 60563-0138
Phone (630) 357-9699

Other identifiers 1

IdentifierTypeStateIssuer
02215165OtherILBLUE CROSS BLUE SHIELD GROUP

Other names 2

  • Easter Seals DuPage Other name
  • Easterseals DuPage & Fox Valley Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050701000395 IL Part B Supplier - Clinic/Group Practice 7113963919 Receives reassigned benefits from 16 practitioners
Practice locations: Elgin, IL; Naperville, IL; Villa Park, IL

National Provider Directory

National Provider Directory

Locations

8602 Solutions Ctr
Chicago, IL 60677

1135 Bowes Rd
#B
Elgin, IL 60123
Phone (847) 742-3264

1555 Bond St
Ste 115
Naperville, IL 60563
Phone (630) 357-9699

698 S Route 59
Naperville, IL 60540
Phone (630) 357-9699

830 S Addison Ave
Villa Park, IL 60181
Phone (630) 620-4433

Practitioners & affiliated clinicians

Practitioners 82

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.

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1568460681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S. ADDISON AVENUE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812877",
            "telephone_number": "630-620-4433",
            "fax_number": "630-620-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S. ADDISON AVENUE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "60181",
            "telephone_number": "630-620-4433",
            "fax_number": "630-620-1148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1135 Bowes Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601235541",
            "country_code": "US",
            "telephone_number": "847-742-3264",
            "fax_number": "847-742-9436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1555 Bond St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605630138",
            "country_code": "US",
            "telephone_number": "630-357-9699",
            "fax_number": "630-357-9908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTER SEALS DUPAGE AND THE FOX VALLEY REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "FORTHOFER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "630-620-4433"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Augmentative Communication",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GROUP",
            "identifier": "02215165",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easter Seals DuPage",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Easter Seals DuPage",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Easterseals DuPage & Fox Valley",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Villa Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.