CMS-1500 Box 24J / 33a • NPI
1629096417
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
208100000X (CMS 25)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation
Box 32 Service Location & ZIP+4
1860 S BELL SCHOOL RD, CHERRY VALLEY, IL, 61016-9372
✓ 9-Digit EDI 837 ZIP+4 (61016-9372)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1629096417 (OPTIMUM REHABILITATION AND CHIROPRACTIC, LTD.) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1629096417 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | OPTIMUM REHABILITATION AND CHIROPRACTIC, LTD. |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation NUCC Code: 208100000X (Physical Medicine & Rehabilitation) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1860 S BELL SCHOOL RD, CHERRY VALLEY, IL, 61016-9372 |
| Practice Telephone / Fax | Tel: (815) 580-8270 | Fax: (815) 580-8278 |
| Administrative Mailing Address | 1860 S BELL SCHOOL RD, CHERRY VALLEY, IL, 61016-9372 |
| Enumeration & Last Sync | Enumerated: 2006-07-18 | CMS Record Updated: 2012-06-27 |
| Authorized Official | JAMES DRAKE (President) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208100000X)
What Does Taxonomy Code 208100000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208100000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (OPTIMUM REHABILITATION AND CHIROPRACTIC, LTD.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
111N00000X — ChiropractorPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor | State: IL | License: 38-010047 | Primary: Secondary |
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: IL | License: 070.011203 | Primary: Secondary |
208100000X — Physical Medicine & RehabilitationPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation | State: IL | License: 036056126 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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