NPIMap

Organization Active NPI

Activcore Rehabilitation Centers of Illinois, P.C.

  • Physical Therapy Clinic/Center
  • Itasca, IL
National Provider Identifier
1598178691
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ACTIVCORE REHABILITATION CENTERS OF ILLINOIS, P.C.
Practice address
500 Park Blvd
Itasca, IL 60143-3121
Phone
(800) 455-8982
NPI assigned
Jun 5, 2014
Last updated
Jun 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Ian Kornbluth, P.T.NPI 1326199316
Title
Owner and Physical Therapist
Phone
(609) 651-3155

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

500 Park Blvd
Itasca, IL 60143-3121

Mailing address

83 Princeton Ave
Suite 3-B
Hopewell, NJ 08525-2020
Phone (800) 455-8982

National Provider Directory

National Provider Directory

Locations

83 Princeton Ave
Ste 3B
Hopewell, NJ 08525
Phone (609) 466-9004

Practitioners & affiliated clinicians

Practitioners 1

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": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1598178691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 PRINCETON AVE",
            "address_2": "SUITE 3-B",
            "city": "HOPEWELL",
            "state": "NJ",
            "postal_code": "085252020",
            "telephone_number": "800-455-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK BLVD",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601433121",
            "telephone_number": "800-455-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVCORE REHABILITATION CENTERS OF ILLINOIS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "KORNBLUTH",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "OWNER AND PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "609-651-3155",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Itasca, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.