Healthcare Provider Details

I. General information

NPI: 1376006619
Provider Name (Legal Business Name): ELEVATE PHYSICAL THERAPY AND FITNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7607 NORTH AVE
RIVER FOREST IL
60305-1105
US

IV. Provider business mailing address

7607 NORTH AVE FRNT
RIVER FOREST IL
60305-1105
US

V. Phone/Fax

Practice location:
  • Phone: 847-447-3098
  • Fax:
Mailing address:
  • Phone: 847-447-3098
  • Fax: 312-312-9631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SEAN MCINERNEY
Title or Position: OWNER
Credential:
Phone: 630-308-1313