Healthcare Provider Details

I. General information

NPI: 1952220477
Provider Name (Legal Business Name): JOHN RAPP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4657 N LINCOLN AVE
CHICAGO IL
60625-2024
US

IV. Provider business mailing address

1338 W EDDY ST APT 1
CHICAGO IL
60657-9531
US

V. Phone/Fax

Practice location:
  • Phone: 773-989-6472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.040024
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: