IndividualActive
Nathan Richardson, PTA
NPI 1457019986 · Physical Therapy Assistant · Glen Carbon, IL
Provider details
- NPI number
- 1457019986
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 160.008987 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
400 S Station Rd
Glen Carbon, IL 62034-2743
Phone: (618) 288-5014
Approximate (ZIP-level) locationGet directions
Mailing address
409 W Wall St
Mulberry Grove, IL 62262-1017
Registry dates
- Enumerated
- 2021-12-01
- Last updated
- 2021-12-01
- Certified
- 2021-12-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.