Healthcare Provider Details
I. General information
NPI: 1063458982
Provider Name (Legal Business Name): INTEGRITY PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2006
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4819 W IRVING PARK RD
CHICAGO IL
60641-2719
US
IV. Provider business mailing address
2300 COIT RD SUITE 300
PLANO TX
75075-3768
US
V. Phone/Fax
- Phone: 773-282-9751
- Fax: 773-282-3209
- Phone: 469-467-8705
- Fax: 267-321-2550
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAYNE
FLECK-POOL
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 469-467-8705