Individual provider Active NPI

Dominique Marie Greve, P.T.

  • Physical Therapist
  • Buffalo Grove, IL
National Provider Identifier
1700167764
Registry record updated Sep 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070015486 Issued in IL
Practice address
150 Weiland Rd
Buffalo Grove, IL 60089-7047
Phone
(847) 465-0200
NPI assigned
Sep 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070015486 IL Primary

Addresses

Primary practice location

150 Weiland Rd
Buffalo Grove, IL 60089-7047

Mailing address

45 Woodridge LN
Buffalo Grove, IL 60089-1546
Phone (847) 520-9092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070015486ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1315180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315180800000",
    "number": "1700167764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WOODRIDGE LN",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891546",
            "telephone_number": "847-520-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 WEILAND RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600897047",
            "telephone_number": "847-465-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREVE",
        "first_name": "DOMINIQUE",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-05",
        "last_updated": "2011-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2011; 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.