Organization Active NPI

Physical Therapy & Rehab Specialists, PC

  • Physical Therapist
  • Lombard, IL
National Provider Identifier
1619906377
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY & REHAB SPECIALISTS, PC
Practice address
10 E 22ND St
Ste. #305
Lombard, IL 60148-4977
Phone
(630) 792-9790
Fax
(630) 792-9794
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James A Dallas, LPTNPI 1265465116
Title
Owner
Phone
(630) 792-9790

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X IL Primary

Addresses

Primary practice location

10 E 22ND St
Ste. #305
Lombard, IL 60148-4977

Mailing address

10 E 22ND St
Ste. #305
Lombard, IL 60148-4977
Phone (630) 792-9790

Other identifiers 1

IdentifierTypeStateIssuer
261178660001MedicaidIL

National Provider Directory

National Provider Directory

Locations

6014 N Keystone Ave
Chicago, IL 60646
Phone (773) 267-7340

403 Ogden Ave
Clarendon Hls, IL 60514
Phone (630) 455-0435

6800 Main St
#105
Downers Grove, IL 60516
Phone (630) 963-5085

800 Austin St
Ste 260
Evanston, IL 60202
Phone (847) 475-0200

9662 Franklin Ave
Franklin Park, IL 60131
Phone (847) 455-1577

455 E Butterfield Rd
Lombard, IL 60148
Phone (630) 663-9925

10 E 22nd St
Ste 305
Lombard, IL 60148
Phone (630) 792-9790

1100 Sherman Ave
Ste 110
Naperville, IL 60563
Phone (630) 278-0510

Practitioners & affiliated clinicians

Practitioners 2

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": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619906377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E 22ND ST",
            "address_2": "STE. #305",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484977",
            "telephone_number": "630-792-9790",
            "fax_number": "630-792-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 22ND ST",
            "address_2": "STE. #305",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484977",
            "telephone_number": "630-792-9790",
            "fax_number": "630-792-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY & REHAB SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALLAS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-792-9790",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261178660001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.