Healthcare Provider Details

I. General information

NPI: 1164571592
Provider Name (Legal Business Name): ADRIANA GARCIA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 W TALCOTT #501
CHICAGO IL
60631
US

IV. Provider business mailing address

7447 W TALCOTT #501
CHICAGO IL
60631
US

V. Phone/Fax

Practice location:
  • Phone: 773-631-4112
  • Fax: 773-594-2113
Mailing address:
  • Phone: 773-631-4112
  • Fax: 773-594-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070015478
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: