Susan L Farley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12120024 Issued in WI

Practice address

18000 W Bluemound Rd
Brookfield, WI 53045-2931

Phone

(262) 879-0010

Fax

(262) 879-9781

NPI assigned

Jun 27, 2006

Last updated

Dec 5, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Susan L Youngquist Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Accelerated Rehabilitation Center of Kenosha LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1649566951
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449273600000",
    "number": "1659308559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895330",
            "telephone_number": "262-657-0222",
            "fax_number": "262-657-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18000 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452931",
            "telephone_number": "262-879-0010",
            "fax_number": "262-879-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLEY",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2015-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012149",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12120024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0604410001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659308559",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "YOUNGQUIST",
            "middle_name": "L",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Fahey, M.D.
• Stacey Falkenberg
• Family Options Counseling
• Family Options Counseling, LLC
• Family Podiatry Centers, LTD
• Matthew Farner
• Saba Farooq, MD
• Jennifer Farrell, LPC
• Susan Torke Farrell, MS/CCC/SLP
• Jessica Fasanello, MS,CRC,LPC

• Physical Therapist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2015; 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.