Provider Demographics
NPI:1275500431
Name:SAIA, RICHARD J (DPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:SAIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:180 WATERLOO COMMONS DR STE 101
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298-1081
Practice Address - Country:US
Practice Address - Phone:618-939-5555
Practice Address - Fax:618-939-3424
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01412225100000X
IL070004239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$002Medicaid
ILP00287608Medicare PIN
ILK19221Medicare ID - Type Unspecified
IL$$$$$$$$$002Medicaid