Healthcare Provider Details

I. General information

NPI: 1770516809
Provider Name (Legal Business Name): APEX PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SUNSET HILLS PROFESSIONAL CTR
EDWARDSVILLE IL
62025-3760
US

IV. Provider business mailing address

15 APEX DR
HIGHLAND IL
62249-1282
US

V. Phone/Fax

Practice location:
  • Phone: 618-692-4280
  • Fax: 618-692-9730
Mailing address:
  • Phone: 618-651-0444
  • Fax: 618-654-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number056000312
License Number StateIL

VIII. Authorized Official

Name: MR. BRADLEY R PFITZNER
Title or Position: CEO/PRESIDENT
Credential: OTR/L
Phone: 618-651-0444