Individual provider Active NPI

Don Octavo

  • Physical Medicine & Rehabilitation Physician
  • Aurora, IL
National Provider Identifier
1740418664
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
070014538 Issued in IL
Practice address
400 N Highland Ave
Aurora, IL 60506-3814
Phone
(630) 978-2532
Fax
(630) 978-2709
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 070014538 IL Primary

Addresses

Primary practice location

400 N Highland Ave
Aurora, IL 60506-3814

Mailing address

400 N Highland Ave
Aurora, IL 60506-3814
Phone (630) 978-2532

Other identifiers 1

IdentifierTypeStateIssuer
070014538OtherLICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218001368 IL Practitioner - Physical Therapist in Private Practice 5597285866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

1440 Somonauk St
Sycamore, IL 60178-2916
Phone (815) 435-5172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070014538ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD CurrentSince Jan 11, 2025 Accepting new patients
Comprehensive Therapeutics LTD CurrentSince Jan 11, 2025 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

1440 Somonauk St
Sycamore, IL 60178
Phone (815) 895-1900

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1740418664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063814",
            "telephone_number": "630-978-2532",
            "fax_number": "630-978-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063814",
            "telephone_number": "630-978-2532",
            "fax_number": "630-978-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCTAVO",
        "first_name": "DON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "070014538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "070014538",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.