Active NPI
Soma Rehab Inc
- Physical Therapist
- Chicago, IL
National Provider Identifier
1902969413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 593354121001 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Physical Therapist
- Chicago, IL
- NPI 1952666968
-
- Occupational Therapist
- Chicago, IL
- NPI 1497208011
-
- Physical Therapy Assistant
- Oak Forest, IL
- NPI 1265966709
-
- Occupational Therapist
- Chicago, IL
- NPI 1619002763
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.