Organization Active NPI

Flex Forward Physical Therapy & Wellness LLC

  • Physical Therapy Clinic/Center
  • Grayslake, IL
National Provider Identifier
1639966211
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FLEX FORWARD PHYSICAL THERAPY & WELLNESS LLC
Practice address
1033 Progress Dr
Grayslake, IL 60030-1672
Phone
(224) 757-0099
Fax
(224) 223-8008
NPI assigned
Apr 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Jacob Paul Giese, PT DPTNPI 1558910067
Title
Owner
Phone
(920) 904-3634

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1033 Progress Dr
Grayslake, IL 60030-1672

Mailing address

1916 Hazelwood Dr
Lindenhurst, IL 60046-7019
Phone (920) 904-3634

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1639966211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 HAZELWOOD DR",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600467019",
            "telephone_number": "920-904-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 PROGRESS DR",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301672",
            "telephone_number": "224-757-0099",
            "fax_number": "224-223-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEX FORWARD PHYSICAL THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "GIESE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-904-3634",
        "authorized_official_credential": "PT DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.