Healthcare Provider Details
I. General information
NPI: 1972620441
Provider Name (Legal Business Name): PHYSICIANS PLUS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6224 S PULASKI RD
CHICAGO IL
60629-4610
US
IV. Provider business mailing address
6224 S PULASKI RD
CHICAGO IL
60629-4610
US
V. Phone/Fax
- Phone: 773-735-8200
- Fax:
- Phone: 773-735-8200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
MARK
S
COHEN
Title or Position: PRESIDENT
Credential: DC
Phone: 773-735-8200