BELVIDERE PHYSICAL THERAPY INC — NPI 1083719033 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in BELVIDERE, IL)

CMS-1500 Box 24J / 33a • NPI

1083719033

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QR0400X (CMS B4[14])

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

1686 HENRY LUCKOW LN, BELVIDERE, IL, 61008

Official NPPES Practice Location

Practice Phone & Referral Fax

(815) 547-4777

Fax: (815) 547-1024

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1083719033 (BELVIDERE PHYSICAL THERAPY INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1083719033` (NPI-2 Organization / Facility)
Provider / Legal Name	BELVIDERE PHYSICAL THERAPY INC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QR0400X` (Clinic/Center, Rehabilitation)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	1686 HENRY LUCKOW LN, BELVIDERE, IL, 61008
Practice Telephone / Fax	Tel: (815) 547-4777 \| Fax: (815) 547-1024
Administrative Mailing Address	PO BOX 150, LIMA, OH, 45802-0150
Enumeration & Last Sync	Enumerated: 2006-09-14 \| CMS Record Updated: 2023-09-28
Authorized Official	STEPHEN KRZMINSKI (Executive Vice President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1686 HENRY LUCKOW LN, BELVIDERE, IL, 61008

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Plain-English Taxonomy & CMS Crosswalk (261QR0400X)

What Does Taxonomy Code 261QR0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QR0400X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code B4[14] (Rehabilitation Agency) • CMS Code B4[14] (Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BELVIDERE PHYSICAL THERAPY INC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QR0400X` — Clinic/Center, Rehabilitation Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BELVIDERE PHYSICAL THERAPY INC (NPI #1083719033)