NPIMap

Organization Active NPI

Spring Grove Physical Therapy LTD

  • Physical Therapist
  • Spring Grove, IL
National Provider Identifier
1669652897
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042618917 Issued in IL
Legal business name
SPRING GROVE PHYSICAL THERAPY LTD
Practice address
2100 Route 12
Suite101
Spring Grove, IL 60081
Phone
(815) 675-0675
NPI assigned
Nov 5, 2007
Last updated
Nov 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Authorized official

Name
Ralph DestephanoNPI 1053429670
Title
President
Phone
(815) 675-0675

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 042618917 IL Primary

Addresses

Primary practice location

2100 Route 12
Suite101
Spring Grove, IL 60081

Mailing address

2100 Route 12
Suite101
Spring Grove, IL 60081
Phone (815) 675-0675

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1669652897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 ROUTE 12",
            "address_2": "SUITE101",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "60081",
            "telephone_number": "815-675-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ROUTE 12",
            "address_2": "SUITE101",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "60081",
            "telephone_number": "815-675-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING GROVE PHYSICAL THERAPY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "DESTEPHANO",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-675-0675"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "042618917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.