Healthcare Provider Details

I. General information

NPI: 1548249337
Provider Name (Legal Business Name): PHYSIO PARTNERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2869 N LINCOLN AVE
CHICAGO IL
60657-4201
US

IV. Provider business mailing address

2869 N LINCOLN AVE
CHICAGO IL
60657-4201
US

V. Phone/Fax

Practice location:
  • Phone: 773-665-9950
  • Fax: 773-665-9947
Mailing address:
  • Phone: 773-665-9950
  • Fax: 773-665-9947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number060008615
License Number StateIL

VIII. Authorized Official

Name: MS. ANGELA WILSON PENNISI
Title or Position: PRESIDENT
Credential: PT
Phone: 773-665-9950