Organization Active NPI

Soma Rehab Inc

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1902969413
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOMA REHAB INC
Practice address
3004 South Pulaski Road
Chicago, IL 60623
Phone
(773) 521-5300
Fax
(773) 521-5305
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ara Maria Boyland, BS PHYSICAL THERAPY
Title
Vice President Physical Therapist
Phone
(773) 521-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X IL Primary

Addresses

Primary practice location

3004 South Pulaski Road
Chicago, IL 60623

Mailing address

3004 South Pulaski Road
Chicago, IL 60623
Phone (773) 521-5300

Other identifiers 1

IdentifierTypeStateIssuer
593354121001MedicaidIL

National Provider Directory

National Provider Directory

Locations

3004 S Pulaski Rd
Chicago, IL 60623
Phone (773) 512-5300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902969413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 SOUTH PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60623",
            "telephone_number": "773-521-5300",
            "fax_number": "773-521-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 SOUTH PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60623",
            "telephone_number": "773-521-5300",
            "fax_number": "773-521-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMA REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOYLAND",
        "authorized_official_first_name": "ARA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "VICE PRESIDENT PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "773-521-5300",
        "authorized_official_credential": "BS PHYSICAL THERAPY"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "593354121001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.