Healthcare Provider Details

I. General information

NPI: 1265459176
Provider Name (Legal Business Name): NORTHWEST PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 HASSELL RD STE C
HOFFMAN ESTATES IL
60169-2171
US

IV. Provider business mailing address

2360 HASSELL RD STE C
HOFFMAN ESTATES IL
60169-2171
US

V. Phone/Fax

Practice location:
  • Phone: 847-517-1900
  • Fax: 847-517-1904
Mailing address:
  • Phone: 847-517-1900
  • Fax: 847-517-1904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateIL

VIII. Authorized Official

Name: VIK KALWANI
Title or Position: MD
Credential:
Phone: 847-517-1900