Physical Therapy Associates, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL THERAPY ASSOCIATES, LLC

Practice address

924 W Custer Ave
Pontiac, IL 61764-1067

Phone

(815) 844-4690

Fax

(815) 844-4810

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeffery C Schade, PHYSICAL THERAPIST

Title

Owner

Phone

(815) 844-4690

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Champion Fitness Inc

  • Physical Therapy Clinic/Center
  • Pontiac, IL
  • NPI 1407801012

  Member Of

  NPD member

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1790730166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 W CUSTER AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617641067",
            "telephone_number": "815-844-4690",
            "fax_number": "815-844-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 W CUSTER AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617641067",
            "telephone_number": "815-844-4690",
            "fax_number": "815-844-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "SCHADE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-844-4690",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5732116",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mukesh V Patel
• Tarlika M Patel, RPH
• Kathryn Paul, PSY.D
• Rex A Pence, BSPHARM
• Reid Allen Pettit, O.D.
• Sara Piller
• Melissa Renee Pina, CDS
• Laura Elizabeth Pittenger
• Vanessa L Pitts, M.D.
• Pontiac CC School Dist 429

• Physical Therapist in Pontiac, IL
• Providers in Pontiac, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.