Organization Active NPI

LTZ Physical Therapy Center Corp

  • Physical Therapy Clinic/Center
  • McHenry, IL
National Provider Identifier
1649541509
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
261QP2000X Issued in IL
Legal business name
LTZ PHYSICAL THERAPY CENTER CORP
Practice address
4117 W Shamrock LN
McHenry, IL 60050-8289
Phone
(630) 890-7530
NPI assigned
Jan 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Zosima Victuelles, RN
Title
Clinical Director
Phone
(630) 890-7530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 261QP2000X IL Primary

Addresses

Primary practice location

4117 W Shamrock LN
McHenry, IL 60050-8289

Mailing address

4117 W Shamrock LN
McHenry, IL 60050-8289
Phone (630) 890-7530

National Provider Directory

National Provider Directory
Tax ID family
LTZ Physical Therapy Center3 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.

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1649541509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 W SHAMROCK LN",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508289",
            "telephone_number": "630-890-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 W SHAMROCK LN",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508289",
            "telephone_number": "630-890-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTZ PHYSICAL THERAPY CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-24",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "VICTUELLES",
        "authorized_official_first_name": "ZOSIMA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "630-890-7530",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "261QP2000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.