ADAPT PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC (NPI# 1104391028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104391028 |
| Entity Type | Organization |
| Organization Name | ADAPT PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC |
| Other Organization Name | UNBROKEN REHAB AND ATHLETICS |
| Practice Address |
125 S Jefferson St Chicago IL 60661-3663 |
| Mailing Address |
5536 N Artesian Ave Apt 2 Chicago IL 60625-3992 |
| Practice Telephone | 8477730298 |
| Mailing Telephone | 8472938171 |
| Enumeration Date | 2018-10-07 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | DR. FREDERICK DUANE SAMPANG (OWNER) |
| Authorized Official Telephone | 8472938171 |
| Authorized Official Credential | PT, DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Unbroken Rehab and Athletics | Doing Business As Name - Organization |
| Street Address |
125 S JEFFERSON ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60661-3663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073035382 | Frederick Duane Sampang | Physical Therapist | 125 S Jefferson St, Chicago, IL 60661-3663 | 2017-07-10 |
| 1376970079 | Joyful Journeys LLC | Early Intervention Provider Agency | 125 S Jefferson St, Unit 2708, Chicago, IL 60661-3663 | 2013-09-26 |
| 1750691937 | Joy Petry | Occupational Therapist | 125 S Jefferson St, Unit 2708, Chicago, IL 60661-3663 | 2010-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053957993 | Safer Foundation | Clinic/Center | 769 W Jackson, Unit G, Chicago, IL 60661 | 2019-11-26 |
| 1174003644 | Safer Foundation | Clinic/Center | 571 W Jackson Blvd, Chicago, IL 60661 | 2018-08-15 |
| 1154835932 | Kathleen Emery | Psychologist | 555 W Jackson Blvd Ste 700, Chicago, IL 60661 | 2017-11-30 |
| 1407384886 | Dana M Trotta | Physical Therapist | 500 W Madison St # C024, Chicago, IL 60661 | 2017-05-30 |
| 1003356874 | Carcena Harvey-burns | Nurse Practitioner | 549 W Randolph St, Chicago, IL 60661 | 2017-02-27 |
| 1962949610 | H & U of West Loop LLC | Dentist | 207 S. Halsted St., Chicago, IL 60661 | 2017-01-19 |
| 1851700066 | Lauren Lew | Physician Assistant | 555 West Madison St. Apt 4903, Chicago, IL 60661 | 2014-08-13 |
| 1306114699 | Telos Therapy, LLC | Physical Therapist | 651 W Washington Blvd Ste 305, Chicago, IL 60661 | 2011-12-01 |
| 1912288622 | Peter Cuauhtemoc Shinnick | Pharmacist | 111 S Halsted, Chicago, IL 60661 | 2011-09-08 |
| 1619292570 | Ramandeep Kaur | Family Medicine | 1717 W. Congress Parkway Kellogg Suite 1125, Rush University Medical Center, Chicago, IL 60661 | 2010-04-05 |
| Find all providers in zip 60661 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487253464 | Chimera Health Pllc | Clinic/Center | 525 N Ada St Apt 10, Chicago, IL 60642-6486 | 2020-10-21 |
| 1093324345 | Motogenix Concierge Physical Therapy | Clinic/Center | 111 S Morgan St Apt 620, Chicago, IL 60607-2732 | 2020-07-23 |
| 1275152746 | Freeform Physical Therapy LLC | Clinic/Center | 2906 W Fullerton Ave, Chicago, IL 60647-2921 | 2020-04-14 |
| 1730736158 | Achieve Performance Lab LLC | Clinic/Center | 1940 W Lawrence Ave Apt 3w, Chicago, IL 60640-4012 | 2019-08-20 |
| 1255997862 | Urban Physical Therapy LLC | Clinic/Center | 345 E Ohio St Apt 2807, Chicago, IL 60611-4065 | 2019-05-20 |
| 1760047179 | Remedy Physical Therapy and Wellness | Clinic/Center | 4636 N Kenmore Ave # 2, Chicago, IL 60640-5039 | 2019-05-01 |
| 1780248864 | Customfit Concierge Medicine, Health and Fitness LLC | Clinic/Center | 1413 W Fillmore St Apt 2, Chicago, IL 60607-4716 | 2019-04-24 |
| 1801356175 | Kinetic Care Physical Therapy LLC | Clinic/Center | 3245 N Ashland Ave Apt 2a, Chicago, IL 60657-4087 | 2019-03-22 |
| 1760952626 | Prep Performance Center, LLC | Clinic/Center | 4022 N Rockwell Street, Chicago, IL 60618 | 2018-12-04 |
| 1699272864 | Athletico, Ltd. | Clinic/Center | 2520 N Elston Ave, Chicago, IL 60647-2004 | 2018-04-12 |
| 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.