Healthcare Provider Details
I. General information
NPI: 1477335222
Provider Name (Legal Business Name): SUMMIT PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2023
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1509 WILSON AVE
WHEATON IL
60189-6833
US
IV. Provider business mailing address
1509 WILSON AVE
WHEATON IL
60189-6833
US
V. Phone/Fax
- Phone: 312-307-2339
- Fax:
- Phone: 312-307-2339
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANN
COLLEEN
NASVYTIS
Title or Position: DR/OWNER
Credential: DPT
Phone: 312-307-2339