NPIMap

Organization Active NPI

Physical Therapy and Sports Injury Rehabilitation

  • Athletic Trainer
  • Tinley Park, IL
National Provider Identifier
1871610808
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION
Practice address
17236 Harlem Ave
Tinley Park, IL 60477-6619
Phone
(708) 633-8379
Fax
(708) 633-8614
NPI assigned
Mar 23, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Gregory Walter Kaumeyer, P.T.
Title
Co-Owner
Phone
(708) 633-8379

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X
Physical Therapist 225100000X
Sports Physical Therapist 2251S0007X
Orthopedic Physical Therapist 2251X0800X
Physical Therapy Assistant 225200000X
Athletic Trainer 2255A2300X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

17236 Harlem Ave
Tinley Park, IL 60477-6619

Mailing address

17236 Harlem Ave
Tinley Park, IL 60477-6619
Phone (708) 633-8379

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy and Sports Injury Rehabilitation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1871610808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17236 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776619",
            "telephone_number": "708-633-8379",
            "fax_number": "708-633-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17236 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776619",
            "telephone_number": "708-633-8379",
            "fax_number": "708-633-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KAUMEYER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "708-633-8379",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.