NPIMap

Organization Active NPI

Integrative Rehabmedicine SC

Doing business as Medlux Rehab & Wellness

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • Rockford, IL
National Provider Identifier
1902014285
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081H0002X
License
036-110166 Issued in IL
Legal business name
INTEGRATIVE REHABMEDICINE SC
Doing business as
Medlux Rehab & Wellness
Practice address
345 Executive Pkwy Ste M4
Rockford, IL 61107-5291
Phone
(815) 381-8514
NPI assigned
May 18, 2007
Last updated
Apr 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Authorized official

Name
Dr. Ricardo Alfonzo Knight, MD, MBANPI 1760436067
Title
President
Phone
(630) 873-5425

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)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician 2081H0002X 036-110166 IL Primary

Addresses

Primary practice location

345 Executive Pkwy Ste M4
Rockford, IL 61107-5291

Mailing address

345 Executive Pkwy Ste M4
Rockford, IL 61107-5291
Phone (815) 381-8514

Other names 1

  • Medlux Rehab & Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070522000532 IL Part B Supplier - Clinic/Group Practice 8022115252 Receives reassigned benefits from 17 practitioners
Practice locations: Rockford, IL; Rolling Meadows, IL; Prospect Heights, IL; Palatine, IL; Sterling, IL; Sycamore, IL; McHenry, IL; Olympia Fields, IL…
O20180213001665 WI Part B Supplier - Clinic/Group Practice 8022115252 Receives reassigned benefits from 6 practitioners
Practice locations: Madison, WI; Milwaukee, WI

National Provider Directory

National Provider Directory

Locations

2250 Pearl St
Belvidere, IL 61008
Phone (815) 544-0358

550 America Ct
Lake Zurich, IL 60047
Phone (847) 307-6990

202 N Show Place Dr
Unit 101
Rockford, IL 61107
Phone (815) 332-3700

4225 Kirchoff Rd
Rolling Meadows, IL 60008
Phone (224) 456-6662

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1902014285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 EXECUTIVE PKWY STE M4",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075291",
            "telephone_number": "815-381-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 EXECUTIVE PKWY STE M4",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075291",
            "telephone_number": "815-381-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE REHABMEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "ALFONZO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-873-5425",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "2081H0002X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036-110166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medlux Rehab & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.

Verify at the official NPI Registry.