Active NPI
Perform Physical Therapy, Inc.
- Physical Therapy Clinic/Center
- Countryside, IL
National Provider Identifier
1841600673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 070-008575
- Legal business name
- PERFORM PHYSICAL THERAPY, INC.
- Practice address
- 7023 Willow Springs Rd
Suite 101
Countryside, IL 60525-4841 - Phone
- (708) 937-9249
- NPI assigned
- May 1, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle Fink, PT
- Title
- Physical Therapist, Owner
- Phone
- (773) 251-9491
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 070-008575 | IL | Primary |
Addresses
Primary practice location
7023 Willow Springs Rd
Suite 101
Countryside, IL 60525-4841
Mailing address
7023 Willow Springs Rd
Suite 101
Countryside, IL 60525-4841
Phone (708) 937-9249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150901001720 | IL | Part B Supplier - Clinic/Group Practice | 6507172871 |
Receives reassigned benefits from 6 practitioners Practice locations: Countryside, IL |
National Provider Directory
National Provider DirectoryLocations
7023 Willow Springs Rd
Ste 101
Countryside, IL 60525
Phone (708) 937-9249
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Countryside, IL
- NPI 1598688574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1441238400000",
"number": "1841600673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7023 WILLOW SPRINGS RD",
"address_2": "SUITE 101",
"city": "COUNTRYSIDE",
"state": "IL",
"postal_code": "605254841",
"telephone_number": "708-937-9249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7023 WILLOW SPRINGS RD",
"address_2": "SUITE 101",
"city": "COUNTRYSIDE",
"state": "IL",
"postal_code": "605254841",
"telephone_number": "708-937-9249"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PERFORM PHYSICAL THERAPY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-05-01",
"last_updated": "2015-09-03",
"status": "A",
"authorized_official_last_name": "FINK",
"authorized_official_first_name": "MICHELLE",
"authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
"authorized_official_telephone_number": "773-251-9491",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "IL",
"license": "070-008575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Countryside, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.