Individual provider Active NPI

Robert K Griffin, PT

  • Physical Therapist
  • Orland Park, IL
National Provider Identifier
1780862573
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070016187 Issued in IL
Practice address
15441 S 94TH Ave
Orland Park, IL 60462-3827
Phone
(708) 981-3715
Fax
(708) 315-7087
NPI assigned
Feb 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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 070016187 IL Primary

Addresses

Primary practice location

15441 S 94TH Ave
Orland Park, IL 60462-3827

Mailing address

PO Box 220
Westmont, IL 60559-0220
Phone (708) 590-6663

Other practice location 1

4746 N Cumberland Ave
Chicago, IL 60656-4239
Phone (773) 417-8901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080317000407 IL Practitioner - Physical Therapist in Private Practice 6709961642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physical Therapy, LLCGroup PAC ID 2466998398, 43 clinicians

Practice addresses (Care Compare)

15441 S 94TH Ave
Orland Park, IL 60462-3827
Phone (708) 981-3715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070016187ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipt Management Services, Inc. Physical Therapist CurrentSince Nov 12, 2018 Accepting new patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Occusport Services Inc. Physical Therapist Past Accepting new patients

Locations

4746 N Cumberland Ave
Chicago, IL 60656
Phone (773) 417-8901

1103 S State St
Ste 300
Chicago, IL 60605
Phone (312) 877-5101

15441 S 94th Ave
Orland Park, IL 60462
Phone (708) 981-3715

Organizations & group practices 3

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1780862573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605590220",
            "telephone_number": "708-590-6663",
            "fax_number": "708-469-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15441 S 94TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623827",
            "telephone_number": "708-981-3715",
            "fax_number": "708-315-7087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4746 N Cumberland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606564239",
            "country_code": "US",
            "telephone_number": "773-417-8901",
            "fax_number": "773-717-5607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "ROBERT",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.