Active NPI
Sara J Vanderbloomer, P.T.
- Physical Therapist
- Gurnee, IL
National Provider Identifier
1831358019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.014838
- Practice address
- 1125 N Delany Rd
Gurnee, IL 60031-2007 - Phone
- (847) 244-7070
- Fax
- (847) 244-7071
- NPI assigned
- Jun 3, 2008
- Last updated
- Apr 9, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.014838 | IL | Primary |
Addresses
Primary practice location
1125 N Delany Rd
Gurnee, IL 60031-2007
Mailing address
1125 N Delany Rd
Gurnee, IL 60031-2007
Phone (847) 244-7070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.014838 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT Holdings, LLC | Physical Therapist | Current | Accepting new patients |
Locations
1125 N Delany Rd
Gurnee, IL 60031
Phone (847) 234-4707
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428537600000",
"number": "1831358019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 N DELANY RD",
"city": "GURNEE",
"state": "IL",
"postal_code": "600312007",
"telephone_number": "847-244-7070",
"fax_number": "847-224-7071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 N DELANY RD",
"city": "GURNEE",
"state": "IL",
"postal_code": "600312007",
"telephone_number": "847-244-7070",
"fax_number": "847-244-7071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERBLOOMER",
"first_name": "SARA",
"middle_name": "J",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2015-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.014838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.