Healthcare Provider Details

I. General information

NPI: 1407009509
Provider Name (Legal Business Name): DESI 'AL' FLORES P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AL FLORES PT, CERTMDT, CFCE

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7421 W IRVING PARK RD
CHICAGO IL
60634-2139
US

IV. Provider business mailing address

440 W COLFAX ST UNIT 2433
PALATINE IL
60067-2537
US

V. Phone/Fax

Practice location:
  • Phone: 773-312-4090
  • Fax: 866-788-4922
Mailing address:
  • Phone: 847-370-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070011147
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: