Elite Therapeutics and Healthcare, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070011571 Issued in IL

Legal business name

ELITE THERAPEUTICS AND HEALTHCARE, INC

Practice address

536 W Daybreak LN
Round Lake, IL 60073-5696

Phone

(847) 409-6643

Fax

(224) 338-0515

NPI assigned

Jan 12, 2009

Organization subpart

No

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

Authorized official

Name

Nathaniel B Vizcayno

Title

President

Phone

(847) 409-6643

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1881831956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 W DAYBREAK LN",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735696",
            "telephone_number": "847-409-6643",
            "fax_number": "224-338-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 W DAYBREAK LN",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735696",
            "telephone_number": "847-409-6643",
            "fax_number": "224-338-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE THERAPEUTICS AND HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "VIZCAYNO",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-409-6643"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marinela Dilo, DMD
• Rebecca Dressendorfer, M.S. CCC-SLP
• Gini Dutt, M.D.
• Joy Christina Dziadkowiec, CNA
• Linda Lee Eaton, LMT
• Susana Emerick
• Paul Eubanks, LMT
• Fairfield Dental
• Jim Feret, CADC
• Guillermina Figueroa, LCP

• Physical Therapist in Round Lake, IL
• Providers in Round Lake, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.