Healthcare Provider Details

I. General information

NPI: 1649598905
Provider Name (Legal Business Name): MARIA C TORRES PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S RIVERSIDE PLZ SUITE 830
CHICAGO IL
60606-5808
US

IV. Provider business mailing address

10279 S 86TH TER BUILDING 1 UNIT 207
PALOS HILLS IL
60465-1328
US

V. Phone/Fax

Practice location:
  • Phone: 312-416-3804
  • Fax:
Mailing address:
  • Phone: 773-858-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160004504
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: