Healthcare Provider Details

I. General information

NPI: 1063891240
Provider Name (Legal Business Name): CENTER FOR PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 DEWES ST STE B
GLENVIEW IL
60025-4377
US

IV. Provider business mailing address

1800 DEWES ST STE B
GLENVIEW IL
60025-4377
US

V. Phone/Fax

Practice location:
  • Phone: 847-920-7887
  • Fax: 847-423-6190
Mailing address:
  • Phone: 847-920-7887
  • Fax: 847-423-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number070021324
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANICA BURIC
Title or Position: THERAPIST IN CHARGE
Credential: P.T
Phone: 773-827-2355