Rebuilt PT and Performance PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REBUILT PT AND PERFORMANCE PLLC

Practice address

822 S Summit Ave
Villa Park, IL 60181-3207

Phone

(630) 426-1474

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Nicholas Gornick, PT, DPTNPI 1982162368

Title

Owner, Physical Therapist

Phone

(630) 426-1474

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Vincent Gornick, PT, DPT

  • Physical Therapist
  • Villa Park, IL
  • NPI 1982162368
  NPD Authorized official

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1790473296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE N",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 S SUMMIT AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813207",
            "telephone_number": "630-426-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBUILT PT AND PERFORMANCE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "GORNICK",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "630-426-1474",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aslam Qazi, PT
• Sarah Qazi
• Maseera Quraishi, DMD
• Rajiv Puri, Prof. Corp.
• Abdul Razzaq, MD
• Reliamed Healthcare Services LLC
• Madonna Sulit Rheingans
• Hannah Maria Ricci
• Shawn Robertson
• Vickie L Robinson, MS, DT

• Physical Therapy Clinic/Center in Villa Park, IL
• Providers in Villa Park, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.