Samantha Bruesch, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.007691 Issued in IL

Practice address

1870 Silver Cross Blvd Ste 200
New Lenox, IL 60451-8646

Phone

(815) 463-5324

Fax

(815) 462-4004

NPI assigned

Mar 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1699216812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 SILVER CROSS BLVD STE 200",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604518646",
            "telephone_number": "815-463-5324",
            "fax_number": "815-462-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUESCH",
        "first_name": "SAMANTHA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.007691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne Brennan
• Richard John Brenza III, OTR/L
• Bright Beginnings Pediatric Therapy Services, PLLC
• Erica Brkovic, M.S.
• Paris Brown
• Liza Bruni
• Pauline Pakla Bubanko, O.D.
• Steven Andrew Bubanko, O.D.
• Laura M Bucher-Bailey, PHARMD
• Eric Buck, ATC

• Physical Therapy Assistant in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.