Healthcare Provider Details

I. General information

NPI: 1811991235
Provider Name (Legal Business Name): THERASYS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W NORTHWEST HWY
PALATINE IL
60067-1837
US

IV. Provider business mailing address

5005 NEWPORT DR STE 401
ROLLING MEADOWS IL
60008-3840
US

V. Phone/Fax

Practice location:
  • Phone: 847-358-2225
  • Fax: 847-358-8354
Mailing address:
  • Phone: 847-797-1050
  • Fax: 847-797-1337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. WALTER G. CORNETT III
Title or Position: CHAIRMAN OF THE BOARD
Credential: MBA
Phone: 847-631-6235