Healthcare Provider Details

I. General information

NPI: 1194342303
Provider Name (Legal Business Name): RACHAEL A BROVITZ PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5956 E PIMA ST
TUCSON AZ
85712-4375
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 520-885-4636
  • Fax: 520-885-4736
Mailing address:
  • Phone: 630-590-4047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31174
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: