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

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

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