Healthcare Provider Details

I. General information

NPI: 1952896912
Provider Name (Legal Business Name): MICHAEL HINES PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7068 183RD ST
TINLEY PARK IL
60477-3926
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 708-580-4160
  • Fax: 708-850-4161
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070027181
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: