Healthcare Provider Details

I. General information

NPI: 1649881632
Provider Name (Legal Business Name): VINCENT PARISI PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 07/20/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7543 183RD ST
TINLEY PARK IL
60477-6208
US

IV. Provider business mailing address

7543 183RD ST
TINLEY PARK IL
60477-6208
US

V. Phone/Fax

Practice location:
  • Phone: 708-263-2000
  • Fax:
Mailing address:
  • Phone: 708-263-2000
  • Fax: 708-623-2300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1336388
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070028453
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-06911
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: