Healthcare Provider Details
I. General information
NPI: 1033755566
Provider Name (Legal Business Name): ILLINOIS LUNA CARE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2019
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1755 PARK ST STE 200
NAPERVILLE IL
60563-8404
US
IV. Provider business mailing address
PO BOX 290609
NASHVILLE TN
37229-0609
US
V. Phone/Fax
- Phone: 866-525-3175
- Fax: 650-227-9115
- Phone: 866-525-3175
- Fax: 650-227-9115
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LILY
ANN
BELTRAN
Title or Position: PRESIDENT
Credential:
Phone: 949-291-4421