Healthcare Provider Details

I. General information

NPI: 1255602827
Provider Name (Legal Business Name): QUALITY PHYSICAL THERAPY AND REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 03/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6222 S PULASKI RD
CHICAGO IL
60629-4610
US

IV. Provider business mailing address

6222 S PULASKI RD
CHICAGO IL
60629-4610
US

V. Phone/Fax

Practice location:
  • Phone: 773-581-5000
  • Fax: 773-581-7781
Mailing address:
  • Phone: 773-581-5000
  • Fax: 773-581-7781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number070.005217
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number070.005217
License Number StateIL

VIII. Authorized Official

Name: DR. AHMED ZAKY HUSSEIN
Title or Position: PRESIDENT
Credential: PT, MS, DPT
Phone: 773-340-7903