Healthcare Provider Details

I. General information

NPI: 1558778381
Provider Name (Legal Business Name): AMERICAN THERAPY PROVIDERS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 12/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17577 KEDZIE AVE 201
HAZEL CREST IL
60429-2051
US

IV. Provider business mailing address

8501 ROB ROY DR
ORLAND PARK IL
60462-5957
US

V. Phone/Fax

Practice location:
  • Phone: 708-261-3803
  • Fax: 708-570-2936
Mailing address:
  • Phone: 708-261-3803
  • Fax: 708-570-2936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number000441
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number007373
License Number StateIL

VIII. Authorized Official

Name: MR. MOHY OSMAN
Title or Position: OWNER
Credential: P.T, ND, L.ACUPUNCT
Phone: 708-261-3803