Healthcare Provider Details

I. General information

NPI: 1437405727
Provider Name (Legal Business Name): LOUIS C PETRELLI PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2012
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 W TOUHY AVE STE 202
CHICAGO IL
60646-1248
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 773-774-4291
  • Fax: 773-774-4527
Mailing address:
  • Phone: 630-575-1980
  • Fax: 630-928-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070019151
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: