NPIMap

Organization Active NPI

Professional Therapy Services, Inc

  • Physical Therapist
  • Pekin, IL
National Provider Identifier
1578615225
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL THERAPY SERVICES, INC
Practice address
2988 Court St
Pekin, IL 61554-6229
Phone
(309) 353-5940
Fax
(309) 353-1654
NPI assigned
Jan 16, 2007
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Mr. Michael R RileyNPI 1336479807
Title
President
Phone
(618) 234-9705

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

2988 Court St
Pekin, IL 61554-6229

Mailing address

2810 Frank Scott Pkwy W
Suite 824
Belleville, IL 62223-5007
Phone (618) 234-9705

Other identifiers 3

IdentifierTypeStateIssuer
8215184OtherILIL BLUE CROSS BLUE SHIELD
172753OtherILHEALTHLINK PROVIDER NUMBE
C4776OtherILRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000615 IL Part B Supplier - Clinic/Group Practice 0345145843 Receives reassigned benefits from 33 practitioners
Practice locations: Chillicothe, IL; Washington, IL; Peoria, IL; Farmington, IL; Morton, IL

National Provider Directory

National Provider Directory

Locations

54 E Fort St
Farmington, IL 61531

1960 N Henderson St
Galesburg, IL 61401
Phone (309) 344-2456

2988 Court St
Pekin, IL 61554
Phone (309) 347-5989

2338 W Van Winkle Way
Ste 3100
Peoria, IL 61615
Phone (309) 693-9189

119 N Cummings Ln
Washington, IL 61571
Phone (309) 886-2305

66 Cherry Tree Shopping Ctr
Washington, IL 61571
Phone (309) 444-3627

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Apostolic Christian SkylinesPeoria, IL, CCN 145933 Skilled nursing facility Operational/Managerial Control Jan 1, 1995

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1578615225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W",
            "address_2": "SUITE 824",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-234-9705",
            "fax_number": "618-257-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2988 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546229",
            "telephone_number": "309-353-5940",
            "fax_number": "309-353-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-234-9705",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BLUE CROSS BLUE SHIELD",
            "identifier": "8215184",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER NUMBE",
            "identifier": "172753",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C4776",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

Verify at the official NPI Registry.