Healthcare Provider Details

I. General information

NPI: 1841763554
Provider Name (Legal Business Name): NEW JOURNEY PHYSICAL THERAPY, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2019
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1893 SHERIDAN RD STE 206
HIGHLAND PARK IL
60035-2637
US

IV. Provider business mailing address

655 DEERFIELD RD 100 STE 176
DEERFIELD IL
60015-2921
US

V. Phone/Fax

Practice location:
  • Phone: 224-707-0765
  • Fax:
Mailing address:
  • Phone: 224-707-0774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KATHERINE UTTECH
Title or Position: OWNER, PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 224-707-0774