Invictus Sports Medicine LLC
NPI 1639673130ActiveOrganization· Physical Therapist· Lake Forest, IL
Physical Therapist in Lake Forest, Illinois, registered in NPPES in March 2018. The authorized official on file is Amador Ayala, DPT, Owner/Physical Therapist. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1639673130 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 20, 2018 |
| Last updated in NPPES | Apr 14, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 070-023307 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (IL) |
|---|
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