Healthcare Provider Details

I. General information

NPI: 1316086762
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 06/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11824 SOUTHWEST HWY STE 230
PALOS HEIGHTS IL
60463-1085
US

IV. Provider business mailing address

2300 COIT RD SUITE 300
PLANO TX
75075-3768
US

V. Phone/Fax

Practice location:
  • Phone: 708-671-1175
  • Fax: 708-671-1176
Mailing address:
  • Phone: 469-467-8705
  • Fax: 267-321-2550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD S. BINSTEIN
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 610-644-7824