EDGEBROOK PHYSICAL THERAPY, INC. (NPI# 1477923886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477923886 |
Entity Type | Organization |
Organization Name | EDGEBROOK PHYSICAL THERAPY, INC. |
Other Organization Name | CORA PHYSICAL THERAPY - EDGEBROOK |
Practice Address |
1643 N Alpine Rd Rockford IL 61107-1462 |
Mailing Address |
1110 Shawnee Rd Lima OH 45805-3529 |
Practice Telephone | 8152896942 |
Practice Fax Number | 8155471024 |
Mailing Telephone | 4192216717 |
Mailing Fax Number | 4192220507 |
Enumeration Date | 2015-09-28 |
Last Update Date | 2019-10-02 |
Authorized Official Name | MR. BRAD C. ROUSH (EXECUTIVE VICE PRESIDENT) |
Authorized Official Telephone | 4192216712 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
CORA Physical Therapy - Edgebrook | Doing Business As Name - Organization |
Street Address |
1643 N ALPINE RD |
City | ROCKFORD |
State | IL |
Zip Code | 61107-1462 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336679653 | Chelsea Jean Falconer | Physical Therapist | 1643 N Alpine Rd, Rockford, IL 61107-1462 | 2017-06-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
Find all providers in zip 61107 |
Taxonomy Code | 261QR0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558538967 | Willows Health Center | Clinic/Center | 4143 Albright Lane, Rockford, IL 61103 | 2008-05-14 |
1912252651 | Advanced Therapy Solutions | Clinic/Center | 7264 Argus Dr, Rockford, IL 61107-5837 | 2012-07-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386243020 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 2500 Williamson County Pkwy, Suite B, Marion, IL 62959-5271 | 2020-10-23 |
1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
1093320855 | Rci (wrs), LLC. | Clinic/Center | 17 West 580 Butterfield Road, Oakbrook Terrace, IL 60181 | 2020-09-09 |
1558975706 | Rci (wrs), LLC. | Clinic/Center | 370 Bank Dr, Mchenry, IL 60050-0506 | 2020-09-04 |
1588278741 | Rci (wrs), LLC. | Clinic/Center | 1151 S State St, Chicago, IL 60605-2304 | 2020-09-04 |
1487268553 | Rci (wrs), LLC. | Clinic/Center | 15 Tower Ct Ste 235, Gurnee, IL 60031-3354 | 2020-09-04 |
1285248351 | Rci (wrs), LLC. | Clinic/Center | 884 S Rand Rd Ste A, Lake Zurich, IL 60047-3412 | 2020-09-04 |
1295349355 | Rci (wrs), LLC. | Clinic/Center | 140 N Addison Ave Fl 2, Elmhurst, IL 60126-2810 | 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 |
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.