Healthcare Provider Details
I. General information
NPI: 1891589925
Provider Name (Legal Business Name): SOLARA THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2025
Last Update Date: 08/28/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1823 W 47TH ST
CHICAGO IL
60609-3843
US
IV. Provider business mailing address
2835 N SHEFFIELD AVE STE 500
CHICAGO IL
60657-5084
US
V. Phone/Fax
- Phone: 773-296-2400
- Fax:
- Phone: 773-296-2400
- Fax:
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:
MAURICE
BROWNLEE
Title or Position: CEO
Credential: APRB-FPA
Phone: 404-548-1212