Organization Active NPI

Promotion Spinal and Sports Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Northfield, IL
National Provider Identifier
1730411612
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
038008035 Issued in IL
Legal business name
PROMOTION SPINAL AND SPORTS REHABILITATION
Practice address
1845 Oak St Ste 1
Northfield, IL 60093-3022
Phone
(847) 446-5420
Fax
(847) 446-5426
NPI assigned
Feb 3, 2010
Last updated
Mar 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Marina Pajerski, PTNPI 1639193972
Title
Owner
Phone
(847) 446-5420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 038008035 IL Primary

Addresses

Primary practice location

1845 Oak St Ste 1
Northfield, IL 60093-3022

Mailing address

1845 Oak St Ste 1
Northfield, IL 60093-3022
Phone (847) 446-5420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100817001253 IL Part B Supplier - Clinic/Group Practice 8628102340 Receives reassigned benefits from 2 practitioners
Practice locations: Northfield, IL

National Provider Directory

National Provider Directory

Locations

1845 Oak St
Ste 1
Northfield, IL 60093
Phone (847) 446-5420

300 Happ Rd
Ste 107
Northfield, IL 60093
Phone (847) 254-7979

Practitioners & affiliated clinicians

Practitioners 3

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": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1730411612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 OAK ST STE 1",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933022",
            "telephone_number": "847-446-5420",
            "fax_number": "847-446-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 OAK ST STE 1",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933022",
            "telephone_number": "847-446-5420",
            "fax_number": "847-446-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMOTION SPINAL AND SPORTS REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "PAJERSKI",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-446-5420",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "038008035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.