PHYSICAL THERAPY AT HOME LLC (NPI# 1619095668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619095668 |
| Entity Type | Organization |
| Organization Name | PHYSICAL THERAPY AT HOME LLC |
| Practice Address |
3512 Greenwood Ave Wilmette IL 60091 |
| Mailing Address |
3512 Greenwood Ave Wilmette IL 60091-1010 |
| Practice Telephone | 8472511231 |
| Practice Fax Number | 8472511231 |
| Mailing Telephone | 8472511231 |
| Mailing Fax Number | 8472511231 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PRATHAN SIRIVAT (PHYSICAL THERAPIST) |
| Authorized Official Telephone | 8472511231 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PHYSICAL THERAPY PRACTICE | 213058 | 01 |
| Street Address |
3512 GREENWOOD AVE |
| City | WILMETTE |
| State | IL |
| Zip Code | 60091 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588737969 | Ravadee Inphom | Physical Therapist | 3512 Greenwood Ave, Wilmette, IL 60091-1010 | 2006-11-16 |
| 1033282413 | Prathan Sirivat | Physical Therapist | 3512 Greenwood Ave, Wilmette, IL 60091-1010 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689284408 | Tanner Hoegh | Counselor | Address: 825 Green Bay Rd, Suite 200, Wilmette, IL 60091 | 2020-08-06 |
| 1205301082 | Charles Michael Falcone | Anesthesiology | 2743 Illinois Road, Wilmette, IL 60091 | 2018-10-09 |
| 1134646219 | Shari Beth Nivasch | Counselor | 445 Beverly Drive, Wilmette, IL 60091 | 2017-08-29 |
| 1508288440 | Debra Anne Brodd | Chiropractor | 522 Poplar, Wilmette, IL 60091 | 2014-01-13 |
| 1720411085 | Catherine Elizabeth Zwergel | Acupuncturist | 1215 Washington Ave Ste 203, Wilmette, IL 60091 | 2013-08-09 |
| 1447693106 | Michael Joseph Engelman | Dentist | 1625 Sheridan Rd. Suite M, Wilmette, IL 60091 | 2013-04-12 |
| 1720365117 | Anna Kielar | Pharmacist | 811 Greenbay Rd, Wilmette, IL 60091 | 2011-11-14 |
| 1306128368 | Victoriya Kharon | Pharmacist | 811 Greenbay Road, Wilmette, IL 60091 | 2011-09-15 |
| 1154626653 | Mary Jo Schmitz | Physical Therapist | 3330 Old Glenview Rd., Suite 4, Wilmette, IL 60091 | 2011-01-14 |
| 1053622522 | Stephanie Lynn Kutzen | Social Worker | 1925 Lake Avenue, Suite 305, Wilmette, IL 60091 | 2010-06-29 |
| Find all providers in zip 60091 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588737969 | Ravadee Inphom | Physical Therapist | 3512 Greenwood Ave, Wilmette, IL 60091-1010 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992310247 | Direct Mobile Pt and Wellness, LLC | Physical Therapist | 0n553 Dorchester Ave, Wheaton, IL 60187-1709 | 2020-09-14 |
| 1285259507 | Sheila Valencia Punzalan | Physical Therapist | 7825 Crawford Ave, Skokie, IL 60076-3609 | 2020-06-11 |
| 1912471913 | Heidi Moyer | Physical Therapist | 665 W North Ave Ste 500, Lombard, IL 60148-1135 | 2019-01-14 |
| 1801362314 | Eric John Grahn | Physical Therapist | 655 White Oak Way, Yorkville, IL 60560-9581 | 2018-10-23 |
| 1588139141 | Marc Brown | Physical Therapist | 930 Monroe St, Galesburg, IL 61401-2538 | 2018-10-10 |
| 1215388244 | Shefali Chandnani | Physical Therapist | 332 Veneto, Bloomingdale, IL 60108-1036 | 2016-06-30 |
| 1154777373 | Tejaswini Savarkar | Physical Therapist | 1412 Frenchmans Bend Dr, Naperville, IL 60564-9714 | 2016-05-06 |
| 1760879969 | Joseph Albert De Mesa Montemayor | Physical Therapist | 3639 N Ottawa Ave, Unit 2, Chicago, IL 60634-3108 | 2015-04-25 |
| 1740686229 | Cynthia Valaitis | Physical Therapist | 17 Ottawa Ct, Oswego, IL 60543-9165 | 2014-11-11 |
| 1538563671 | Jigeeh Mantujac | Physical Therapist | 4559 Imperial Dr, 3e, Richton Park, IL 60471-2437 | 2014-10-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.