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General NPI Number Information
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NPI Number | 1033448360
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Entity Type | Organization
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Legal Business Name | EXCELLCARE PHYSICAL THERAPY & REHABILITATION NETWORK 2 INC
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 6508 W ARCHER AVE SUITE 4
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City | CHICAGO
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State | IL
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Zip | 60638-2423
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Country | US
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Telephone | 773-313-3711
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Fax | 773-313-3714
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Provider Business Mailing Address
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Address Line | 6508 W ARCHER AVE SUITE 4
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City | CHICAGO
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State | IL
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Zip | 60638-2423
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Country | US
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Telephone | 773-313-3711
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Fax | 773-313-3714
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAL BARADZIEJ
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Credential | LPT
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Telephone | 773-313-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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