Healthcare Provider Details

I. General information

NPI: 1497603542
Provider Name (Legal Business Name): DAISY TORRES PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17800 KEDZIE AVE
HAZEL CREST IL
60429-2029
US

IV. Provider business mailing address

1242 OAK LEAF CT
CRETE IL
60417-2311
US

V. Phone/Fax

Practice location:
  • Phone: 708-213-3825
  • Fax:
Mailing address:
  • Phone: 708-942-0143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: