Healthcare Provider Details

I. General information

NPI: 1609678564
Provider Name (Legal Business Name): THE CREW PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N RACINE AVE
CHICAGO IL
60614-7006
US

IV. Provider business mailing address

3352 N AVERS AVE
CHICAGO IL
60618-5257
US

V. Phone/Fax

Practice location:
  • Phone: 512-940-9537
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREN RACHEL ALEXANDER
Title or Position: OWNER
Credential:
Phone: 512-940-9537