Healthcare Provider Details

I. General information

NPI: 1659481828
Provider Name (Legal Business Name): ORTHOCARE PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6172 S. CASS AVENUE
WESTMONT IL
60559
US

IV. Provider business mailing address

2547 PLAINFIELD/NAPERVILLE ROAD SUITE 152
NAPERVILLE IL
60564-8701
US

V. Phone/Fax

Practice location:
  • Phone: 630-725-1255
  • Fax: 630-725-1222
Mailing address:
  • Phone: 800-974-4378
  • Fax: 630-515-1536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number070-010541
License Number StateIL

VIII. Authorized Official

Name: AARON KRAAI
Title or Position: OWNER
Credential: PT, DPT
Phone: 800-974-4378