SPORTS AND ORTHO P.C (NPI# 1871640565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871640565 |
| Entity Type | Organization |
| Organization Name | SPORTS AND ORTHO P.C |
| Practice Address |
412 W 31st St Chicago IL 60616-3116 |
| Practice Telephone | 3122253119 |
| Practice Fax Number | 3122253219 |
| Mailing Telephone | 3122253119 |
| Mailing Fax Number | 3122253219 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-07-16 |
| Authorized Official Name | DAHLIA FAHMY (OWNER) |
| Authorized Official Telephone | 3123755354 |
| Authorized Official Credential | PT, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 01633349 | 01 |
| Street Address |
412 W 31ST ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60616-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104973841 | Dahlia Fahmy | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2007-01-04 |
| 1396196895 | Payal Korde | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2016-06-26 |
| 1649640988 | Anthony Stuart Gravin | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2015-09-29 |
| 1336410752 | Stella Shaba | Physical Therapy Assistant | 412 W 31st St, Chicago, IL 60616-3116 | 2012-01-17 |
| 1760701791 | Brenda Joy Larson Pittacora | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2010-06-01 |
| 1235461856 | Deanne Brown | Physical Therapy Assistant | 412 W 31st St, Chicago, IL 60616-3116 | 2010-02-06 |
| 1467610121 | Samit Shah | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2008-05-29 |
| 1427234749 | Rebecca Lynn Gardner-reilly | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2008-01-16 |
| 1487701967 | Beth Beaumont | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2007-01-05 |
| 1063569747 | Michelle Shufelt | Physical Therapist | 412 W 31st St, Chicago, IL 60616-3116 | 2007-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558993758 | King Dental, PC | Clinic/Center | 3425 S King Dr, Chicago, IL 60616 | 2020-02-06 |
| 1386286144 | Anais Karel Jackson-gonzalez | Acupuncturist | 2018 S. Michigan Ave., Chicago, IL 60616 | 2019-10-14 |
| 1215499777 | Mashaal F Ikram | Student in an Organized Health Care Education/Training Program | Mercy Hospital and Medical Center, 2525 South Michigan Avenue, Chicago, IL 60616 | 2019-04-03 |
| 1891254223 | Towayn Heaven | Acupuncturist | 2018 S Michigan Ave, Chicago, IL 60616 | 2019-03-15 |
| 1689131518 | Abhishek Santos Pandya | Internal Medicine | 2525 S Michigan Ave., Mercy Hospital and Medical Center, Chicago, IL 60616 | 2019-02-27 |
| 1144703992 | Katelyn Michelle St Martin | Physician Assistant | 2850 S Michigan Ave Ste 100, Chicago, IL 60616 | 2018-09-07 |
| 1902383953 | Healing Empowering & Learning Professionals LLC | Clinic/Center | 2930 S Michigan Ave Ste 100, Chicago, IL 60616 | 2018-07-23 |
| 1437644812 | Puja Bhagwakar | Dentist | 1620 S Michigan Ave Unit 704, Chicago, IL 60616 | 2018-06-27 |
| 1821589110 | David Alexander Sousa Frias | Internal Medicine | 2525 Michigan Ave, Mercy Hospital At Medical Center, Chicago, IL 60616 | 2018-05-23 |
| 1508394933 | Awad Eyecare Sc | Optometrist | 1845 S Michigan Ave Unit 1803, Chicago, IL 60616 | 2017-05-30 |
| Find all providers in zip 60616 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1588278741 | Rci (wrs), LLC. | Clinic/Center | 1151 S State St, Chicago, IL 60605-2304 | 2020-09-04 |
| 1043824287 | Rci (wrs), LLC. | Clinic/Center | 1525 E 55th St Ste 305, Chicago, IL 60615-5576 | 2020-09-04 |
| 1396359469 | Rci (wrs), LLC. | Clinic/Center | 939 W North Ave Ste 300, Chicago, IL 60642-7139 | 2020-09-04 |
| 1134733298 | Rci (wrs), LLC. | Clinic/Center | 444 W Jackson Blvd Lbby 1, Chicago, IL 60606-6951 | 2020-09-04 |
| 1255945317 | Rci (wrs), LLC. | Clinic/Center | 1751 W Division St Unit C-1e, Chicago, IL 60622-4086 | 2020-09-04 |
| 1144834227 | Rci (wrs), LLC. | Clinic/Center | 2400 N Sheffield Ave Ste 100, Chicago, IL 60614-3936 | 2020-09-04 |
| 1306404728 | Rci (wrs), Inc. | Clinic/Center | 1030 N Clark St Fl 6, Chicago, IL 60610-5467 | 2019-05-31 |
| 1831580075 | Avanza Rehabilitation Ltd | Clinic/Center | 3501 E 106th St Ste 102, Chicago, IL 60617-6625 | 2015-02-10 |
| 1417195900 | Total Therapy & Medical Center, Ltd. | Clinic/Center | 4832 N Sheridan Rd, Chicago, IL 60640-3704 | 2009-01-22 |
| Find all providers in CHICAGO | ||||
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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.