Individual provider Active NPI

Ronald Michael Rebmann, D.C

  • Rehabilitation Chiropractor
  • Libertyville, IL
National Provider Identifier
1992884498
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
038-005127 Issued in IL
Practice address
736 Florsheim Dr
Suite 12
Libertyville, IL 60048-3704
Phone
(847) 680-3900
Fax
(847) 680-2026
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 038-005127 IL Primary
Sports Physician Chiropractor 111NS0005X 038-005127 IL

Addresses

Primary practice location

736 Florsheim Dr
Suite 12
Libertyville, IL 60048-3704

Mailing address

736 Florsheim Dr
Suite 12
Libertyville, IL 60048-3704
Phone (847) 680-3900

Other identifiers 1

IdentifierTypeStateIssuer
4922462OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130301000019 IL Practitioner - Chiropractic 0749435782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physical Therapy SC IncGroup PAC ID 9335679489, 4 clinicians

Practice addresses (Care Compare)

1117 S Milwaukee Ave
Suite D11
Libertyville, IL 60048-3704
Phone (847) 680-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-005127ILMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Chiropractic Center SC CurrentSince Mar 1, 2012 Accepting new patients
Affinity Physical Therapy SC Inc CurrentSince Jul 1, 2025 Accepting new patients
Envision Health Clinic PastSince May 31, 2016 Accepting new patients

Locations

1117 S Milwaukee Ave
Ste D11
Libertyville, IL 60048
Phone (847) 680-3900

736 Florsheim Dr
Ste 12
Libertyville, IL 60048
Phone (847) 680-3900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1992884498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 FLORSHEIM DR",
            "address_2": "SUITE 12",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483704",
            "telephone_number": "847-680-3900",
            "fax_number": "847-680-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 FLORSHEIM DR",
            "address_2": "SUITE 12",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483704",
            "telephone_number": "847-680-3900",
            "fax_number": "847-680-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBMANN",
        "first_name": "RONALD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038-005127",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038-005127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4922462",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.