Healthcare Provider Details

I. General information

NPI: 1881215812
Provider Name (Legal Business Name): TOTAL HEALTHCARE HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 N CENTRAL AVE STE 1A
CHICAGO IL
60630-2345
US

IV. Provider business mailing address

710 N DEARBORN ST
CHICAGO IL
60654-5900
US

V. Phone/Fax

Practice location:
  • Phone: 773-701-8048
  • Fax: 630-924-0462
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARC STRONGIN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 312-951-8200