TIDEWATER PHYSICAL THERAPY, LLC – Physical Therapist, NPI 1669493474

TIDEWATER PHYSICAL THERAPY, LLC is a healthcare provider. based in Oak brook, Illinois. specializing in Physical Therapist. The NPI Number for TIDEWATER PHYSICAL THERAPY, LLC is 1669493474

Main info

Organization
Name
TIDEWATER PHYSICAL THERAPY, LLC
NPI
1669493474
Phone
(630) 575-1980
Address
2122 YORK RD STE 300
Authorized Official
TASHEDA BROUGHTON CREDENTIALING MANAGER
Enumeration Date
21 July 2006
Last Update Date
19 November 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:19State licenses:0Digital endpointsOther names

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Provider Addresses for TIDEWATER PHYSICAL THERAPY, LLC

  • 2122 YORK RD STE 300

    OAK BROOK, IL 605231925

    Phone: (630) 575-1980

    Fax: (630) 928-5080

    Type: Mailing

  • New Fidelity Court, Garner, Wake County, North Carolina, 275, United States

    GARNER, NC 275292665

    Phone: (919) 258-2714

    Fax: (410) 648-4878

    Type: Mailing

  • 751, J Clyde Morris Boulevard, City Center, Newport News, Newport News City, Virginia, 23601, United States

    NEWPORT NEWS, VA 236011538

    Phone: (757) 873-2123

    Fax: (757) 873-3848

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60523)

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Frequently asked questions

What is the registry number for TIDEWATER PHYSICAL THERAPY, LLC?
The registry entry for TIDEWATER PHYSICAL THERAPY, LLC shows NPI 1669493474.
Is TIDEWATER PHYSICAL THERAPY, LLC currently accepting referrals based on NPI status?
Registry metadata lists TIDEWATER PHYSICAL THERAPY, LLC as active.
What services align with TIDEWATER PHYSICAL THERAPY, LLC's listing?
TIDEWATER PHYSICAL THERAPY, LLC's public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
Is TIDEWATER PHYSICAL THERAPY, LLC tied to Oak Brook, Illinois?
If you are local to Oak Brook, Illinois, TIDEWATER PHYSICAL THERAPY, LLC may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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