NPIMap

Organization Active NPI

Midwest Performance Rehab, PLLC

  • Physical Therapist
  • Leaf River, IL
National Provider Identifier
1609622158
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MIDWEST PERFORMANCE REHAB, PLLC
Practice address
7212 N Pecatonica Rd
Leaf River, IL 61047-9402
Phone
(630) 809-9838
NPI assigned
Apr 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. Thomas Michael Vant, PT, DPT, ATCNPI 1588419295
Title
President
Phone
(630) 809-9838

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

7212 N Pecatonica Rd
Leaf River, IL 61047-9402

Mailing address

7212 N Pecatonica Rd
Leaf River, IL 61047-9402
Phone (630) 809-9838

Other practice location 1

426 N Center St
Durand, IL 61024
Phone (630) 809-9838

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240605002214 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2466994447 Receives reassigned benefits from 4 practitioners
Practice locations: Durand, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1609622158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 N PECATONICA RD",
            "city": "LEAF RIVER",
            "state": "IL",
            "postal_code": "610479402",
            "telephone_number": "630-809-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7212 N PECATONICA RD",
            "city": "LEAF RIVER",
            "state": "IL",
            "postal_code": "610479402",
            "telephone_number": "630-809-9838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "426 N Center St",
            "address_purpose": "LOCATION",
            "city": "Durand",
            "state": "IL",
            "postal_code": "61024",
            "country_code": "US",
            "telephone_number": "630-809-9838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST PERFORMANCE REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "VANT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-809-9838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leaf River, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.