OrganizationActive
Your Personal Best
NPI 1063758530 · Specialist · Tinley Park, IL
Provider details
- NPI number
- 1063758530
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Ryan King, Manager(773) 280-3784
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
18623 81st Ave
Tinley Park, IL 60487-6279
Phone: (708) 633-1000
Fax: (708) 633-1096
Street-level locationGet directions
Mailing address
18623 81st Ave
Tinley Park, IL 60487-6279
Registry dates
- Enumerated
- 2013-01-02
- Last updated
- 2013-01-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.