Healthcare Provider Details

I. General information

NPI: 1992173868
Provider Name (Legal Business Name): STEPHEN FRANCIS SPIKA JR. PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 W 35TH ST
CHICAGO IL
60616-3532
US

IV. Provider business mailing address

558 W 35TH ST
CHICAGO IL
60616-3532
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-7820
  • Fax:
Mailing address:
  • Phone: 317-621-7820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070022156
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2305209786
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number05013532A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: