Healthcare Provider Details

I. General information

NPI: 1083154348
Provider Name (Legal Business Name): PETER RECHENBERG PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 N RIVER RD STE 100A
ROSEMONT IL
60018-4206
US

IV. Provider business mailing address

6300 N RIVER RD STE 100A
ROSEMONT IL
60018-4206
US

V. Phone/Fax

Practice location:
  • Phone: 312-421-1016
  • Fax: 847-787-7144
Mailing address:
  • Phone: 312-421-1016
  • Fax: 847-787-7144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.023499
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: