Provider Demographics
NPI:1295798379
Name:RUMPELTES, JOHN W (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:RUMPELTES
Suffix:
Gender:M
Credentials:PT
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:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:810 KOKOMO RD
Practice Address - Street 2:STE 155
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5075
Practice Address - Country:US
Practice Address - Phone:808-791-7924
Practice Address - Fax:206-447-1592
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002965225100000X
HIPT5551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8343253Medicaid
WAG8905405Medicare PIN
WAS27259Medicare UPIN
WAGAB09563Medicare PIN