NPIMap

Organization Active NPI

Rebound Fitness and Rehabilitation/Rebound Sports Medicine

  • Clinic/Center
  • Northbrook, IL
National Provider Identifier
1619944378
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
096000933 Issued in IL
Legal business name
REBOUND FITNESS AND REHABILITATION/REBOUND SPORTS MEDICINE
Practice address
666 Dundee Rd
Suite 1002
Northbrook, IL 60062-2727
Phone
(847) 714-7400
Fax
(224) 723-5546
NPI assigned
Mar 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Authorized official

Name
Greg Cadichon, ATC/L
Title
Athletic Trainer/Owner
Phone
(847) 714-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 096000933 IL Primary

Addresses

Primary practice location

666 Dundee Rd
Suite 1002
Northbrook, IL 60062-2727

Mailing address

666 Dundee Rd
Suite 1002
Northbrook, IL 60062-2727
Phone (847) 714-7400

Other names 1

  • Rebound Fitness, Inc. Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110512000406 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2961688700 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Northbrook, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Rebound Fitmess and Rehabilitation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1619944378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 1002",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-714-7400",
            "fax_number": "224-723-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 1002",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-714-7400",
            "fax_number": "224-723-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBOUND FITNESS AND REHABILITATION/REBOUND SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "CADICHON",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "ATHLETIC TRAINER/OWNER",
        "authorized_official_telephone_number": "847-714-7400",
        "authorized_official_credential": "ATC/L"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "096000933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebound Fitness, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.