Healthcare Provider Details

I. General information

NPI: 1235104571
Provider Name (Legal Business Name): AMERICAN PHYSICAL THERAPY & SPORTS MEDICINE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1783 SOUTH WASHINGTON AMERICAN PHYSICAL THERAPY & SPORTS MEDICINE CLINIC
NAPERVILLE IL
60565
US

IV. Provider business mailing address

1840 SLIPPERY ROCK RD BHARAT MALHOTRA
NAPERVILLE IL
60565
US

V. Phone/Fax

Practice location:
  • Phone: 630-717-6188
  • Fax: 630-717-8842
Mailing address:
  • Phone: 630-717-6188
  • Fax: 630-717-8842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RENU SHARMA
Title or Position: PRESIDENT
Credential: ROT
Phone: 630-717-6188