Form Physical Therapy, LLC
NPI 1700516820ActiveOrganization· Physical Therapist· Westchester, IL
Physical Therapist in Westchester, Illinois, registered in NPPES in June 2022. The authorized official on file is Kevin Elavia, DPT, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1700516820 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 13, 2022 |
| Last updated in NPPES | Jul 26, 2023 |
| Certified by provider | Jul 26, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
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 - Clinic/Group Practice (IL) |
|---|
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