Healthcare Provider Details

I. General information

NPI: 1033638010
Provider Name (Legal Business Name): DYNAMIC PHYSICAL THERAPY CHICAGO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W HURON ST STE 2004
CHICAGO IL
60654-3951
US

IV. Provider business mailing address

220 W HURON ST STE 2004
CHICAGO IL
60654-3951
US

V. Phone/Fax

Practice location:
  • Phone: 312-778-6455
  • Fax: 312-896-5993
Mailing address:
  • Phone: 312-643-1555
  • Fax: 312-896-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MEREDITH FRANCZYK
Title or Position: OWNER
Credential: PT
Phone: 773-606-9196