NPIMap

Organization Active NPI

Pediatric Rehabilitation Services

  • Rehabilitation Clinic/Center
  • Downers Grove, IL
National Provider Identifier
1639221682
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PEDIATRIC REHABILITATION SERVICES
Practice address
5201 Walnut Avenue
Ste 4
Downers Grove, IL 60515-4025
Phone
(630) 964-4707
Fax
(630) 964-4797
NPI assigned
Jan 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Mrs. Elizabeth Johnson Maruvama, OTRL
Title
Partner
Phone
(630) 964-4707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

5201 Walnut Avenue
Ste 4
Downers Grove, IL 60515-4025

Mailing address

5201 Walnut Avenue
Ste 4
Downers Grove, IL 60515-4025
Phone (630) 964-4707

National Provider Directory

National Provider Directory

Locations

5201 Walnut Ave
Ste 4
Downers Grove, IL 60515
Phone (630) 964-4025

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639221682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WALNUT AVENUE",
            "address_2": "STE 4",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154025",
            "telephone_number": "630-964-4707",
            "fax_number": "630-964-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WALNUT AVENUE",
            "address_2": "STE 4",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154025",
            "telephone_number": "630-964-4707",
            "fax_number": "630-964-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARUVAMA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "630-964-4707",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, 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.