Herbert Deiters, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070015746 Issued in IL

Practice address

15750 Marian Dr
Homer Glen, IL 60491-6200

Phone

(708) 645-3400

NPI assigned

May 24, 2007

Last updated

Sep 14, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Comprehensive Physical Medicine, SC

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  • NPI 1245506724
  NPD
• Goesel Chiropractic Health Center SC

  • Chiropractor
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  • NPI 1033277538
  NPD (past)
• Occusport Services Inc.

  • Physical Therapist
  • Lockport, IL
  • NPI 1952350886
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1992916605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "888-584-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15750 MARIAN DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604916200",
            "telephone_number": "708-645-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITERS",
        "first_name": "HERBERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "1623066",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "367885100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "1619908",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giovanna Dalmares
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• Teresa Davis-Fewkes, LCPC
• Alan Robert De Angelo, D.D.S.
• Michele Marie Deering, P.T., O.C.S.
• Brittany Dempsey, OTR/L
• Dental Sleep Center Richard a Craig DDS LTD (Midwest Dental Sleep Center)
• Dental Sleep Center Richard a Craig DDS LTD (Midwest Dental Sleep Center)
• Kathryn Anne Desalvo, SLP
• Diana M. Burda, MD SC

• Physical Therapist in Homer Glen, IL
• Providers in Homer Glen, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.