MEDICARE: RESCULPT PHYSICAL THERAPY AND WELLNESS LLC

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	225100000X	Physical Therapist	070021475	IL

General Provider Information

NPI Number	:	1891221685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESCULPT PHYSICAL THERAPY AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	1895 CLAVEY RD
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-4373
Country	:	US
Telephone Number	:	847-370-1525
Fax Number	:

Provider Business Practice Location Address
First Line	:	1895 CLAVEY RD
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-4373
Country	:	US
Telephone Number	:	847-370-1525
Fax Number	:	847-810-0046

Authorized Official
Title or Position	:	OWNER
Name	:	CATHERIYA CURRAN
Credential	:	DPT
Telephone Number	:	847-370-1525

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	02/08/2021

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