Pain Relief Treatment Centers of Bloomingdale Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PAIN RELIEF TREATMENT CENTERS OF BLOOMINGDALE INC

Practice address

290 Springfield Dr
Suite 255
Bloomingdale, IL 60108-2214

Phone

(630) 924-1111

Fax

(630) 924-0841

NPI assigned

Jan 7, 2016

Organization subpart

No

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

Authorized official

Name

Shannon Ruby

Title

Office Manager

Phone

(330) 219-4152

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1740646660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 SPRINGFIELD DR",
            "address_2": "SUITE 255",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082214",
            "telephone_number": "630-924-1111",
            "fax_number": "630-924-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 SPRINGFIELD DR",
            "address_2": "SUITE 255",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082214",
            "telephone_number": "630-924-1111",
            "fax_number": "630-924-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN RELIEF TREATMENT CENTERS OF BLOOMINGDALE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "RUBY",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-219-4152"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.