Healthcare Provider Details

I. General information

NPI: 1528594439
Provider Name (Legal Business Name): PHILIP RUDGE ARCA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E HURON ST STE 700
CHICAGO IL
60611-2999
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 312-640-1112
  • Fax: 312-640-1011
Mailing address:
  • Phone: 630-575-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070023125
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: