Individual provider Active NPI

Drew Alan Fitzanko, PT

  • Physical Therapist
  • Byron, IL
National Provider Identifier
1891754776
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070010923 Issued in IL
Practice address
209 N. Union St.
Byron, IL 61010-0600
Phone
(815) 234-5553
Fax
(815) 234-5557
NPI assigned
Mar 21, 2006
Last updated
Sep 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070010923 IL Primary

Addresses

Primary practice location

209 N. Union St.
Byron, IL 61010-0600

Mailing address

209 S Union St
Byron, IL 61010-1458
Phone (815) 234-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070208000453 IL Practitioner - Physical Therapist in Private Practice 7012919772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Rehab Specialists PLLCGroup PAC ID 8527492354, 13 clinicians

Practice addresses (Care Compare)

209 N Union St
Byron, IL 61010-8626
Phone (815) 234-5553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070010923ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Rehab Specialists PLLC Physical Therapist CurrentSince Feb 1, 2020 Accepting new patients
Belvidere Rehab & Sports Medicine Physical Therapist PastSince Nov 1, 2002 Accepting new patients

Locations

1255 Logan Ave
Belvidere, IL 61008
Phone (815) 547-4733

201 Lincoln Statue Dr
Dixon, IL 61021
Phone (815) 284-1700

201 Lincoln Statue Dr
Ste 102
Dixon, IL 61021
Phone (815) 284-1700

2662 McFarland Rd
Rockford, IL 61107
Phone (815) 226-8780

Organizations & group practices 2

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1891754776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S UNION ST",
            "city": "BYRON",
            "state": "IL",
            "postal_code": "610101458",
            "telephone_number": "815-234-5553",
            "fax_number": "815-234-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N. UNION ST.",
            "city": "BYRON",
            "state": "IL",
            "postal_code": "610100600",
            "telephone_number": "815-234-5553",
            "fax_number": "815-234-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZANKO",
        "first_name": "DREW",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070010923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.