MEDICARE: WIEBUSCH PHYSICAL THERAPY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01634891	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1689681520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WIEBUSCH PHYSICAL THERAPY, INC

Provider Business Mailing Address
First Line	:	1701 WEST WRIGHTWOOD AVENUE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-7335
Country	:	US
Telephone Number	:	773-750-7648
Fax Number	:	773-327-7470

Provider Business Practice Location Address
First Line	:	900 N NORTH BRANCH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-4278
Country	:	US
Telephone Number	:	773-750-7648
Fax Number	:	773-327-7470

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. TRACI WIEBUSCH HILL
Credential	:	MPT
Telephone Number	:	773-750-7648

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/21/2022

Similar Medicare Providers

1740297670 — MRS. TRACI WIEBUSCH HILL MPT
Practice Location Address:

900 N NORTH BRANCH ST
CHICAGO, IL
60622-4278

Practice Phone: 773-750-7648
Practice Fax: 773-327-7470

1164673547 — MRS. KRISTINA KOBBEMAN COFER ATC
Practice Location Address:

900 N NORTH BRANCH ST
CHICAGO, IL
60642-4278

Practice Phone: 773-458-3070
Practice Fax:

1407085426 — ANGELA SEARS
Practice Location Address:

6050 S STONY ISLAND AVE APT 2S
CHICAGO, IL
60637-4278

Practice Phone: 773-519-9262
Practice Fax:

1629736517 — MEGA LAB SERVICES INC
Practice Location Address:

6447 N SACRAMENTO AVE APT 507
CHICAGO, IL
60645-4278

Practice Phone: 773-683-4787
Practice Fax:

1538912092 — CHRISTINA MARIE DYER LCPC
Practice Location Address:

1200 N ASHLAND AVE STE 500
CHICAGO, IL
60622-8327

Practice Phone: 815-476-5600
Practice Fax:

1053264333 — TTS BILLING AND MANAGEMENT LLC
Practice Location Address:

1608 W DIVISION ST , #208
CHICAGO, IL
60622

Practice Phone: 847-471-1149
Practice Fax:

Directions to “WIEBUSCH PHYSICAL THERAPY, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.