MEDICARE: PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225100000X	Physical Therapist
3	2251S0007X	Sports Physical Therapist
4	2251X0800X	Orthopedic Physical Therapist
5	225200000X	Physical Therapy Assistant
6	225X00000X	Occupational Therapist
7	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1871610808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION

Provider Business Mailing Address
First Line	:	17236 HARLEM AVE
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-6619
Country	:	US
Telephone Number	:	708-633-8379
Fax Number	:	708-633-8614

Provider Business Practice Location Address
First Line	:	17236 HARLEM AVE
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-6619
Country	:	US
Telephone Number	:	708-633-8379
Fax Number	:	708-633-8614

Authorized Official
Title or Position	:	CO-OWNER
Name	:	GREGORY WALTER KAUMEYER
Credential	:	P.T.
Telephone Number	:	708-633-8379

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	09/11/2025

Similar Medicare Providers

1003935180 — PTSIR INDUSTRIAL REHABILITATION
Practice Location Address:

17236 HARLEM AVE
TINLEY PARK, IL
60477-6619

Practice Phone: 708-633-8379
Practice Fax: 708-633-8614

1992978175 — TRAVIS J SPAGNOLA
Practice Location Address:

17236 HARLEM AVE
TINLEY PARK, IL
60477-6619

Practice Phone: 708-633-8379
Practice Fax: 708-633-8614

1013735398 — JESSICA DEJONG
Practice Location Address:

17236 HARLEM AVE
TINLEY PARK, IL
60477-6619

Practice Phone: 708-633-8379
Practice Fax:

1881635159 — JOHN ADAM WAGNER DC
Practice Location Address:

411 HYDE PARK
DOYLESTOWN, PA
18902-6619

Practice Phone: 215-230-8100
Practice Fax: 215-230-8892

1184646861 — UTAH CVS PHARMACY LLC
Practice Location Address:

7025 S PARK CENTRE DR
SALT LAKE CITY, UT
84121-6619

Practice Phone: 801-255-2566
Practice Fax: 801-252-4970

1790894418 — MATTHEW C SERLO MPT
Practice Location Address:

236 PONTE VEDRA PARK DR , SUITE 300
PONTE VEDRA, FL
32082-6619

Practice Phone: 678-459-3758
Practice Fax:

Directions to “PHYSICAL THERAPY AND SPORTS INJURY REHABILITATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.