Healthcare Provider Details

I. General information

NPI: 1568069045
Provider Name (Legal Business Name): ARTHUR E CANO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8057 S CICERO AVE
CHICAGO IL
60652-2003
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TOWNSHIP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 773-922-0105
  • Fax: 773-922-0106
Mailing address:
  • Phone: 586-350-2644
  • Fax: 586-541-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.025534
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: