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General NPI Number Information
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NPI Number | 1043775844
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Entity Type | Organization
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Legal Business Name | EXEMPLAR PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 1830 W FOSTER AVE STE CW
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City | CHICAGO
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State | IL
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Zip | 60640-1087
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Country | US
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Telephone | 773-516-4146
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 W FOSTER AVE UNIT CW
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City | CHICAGO
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State | IL
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Zip | 60640-1087
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Country | US
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Telephone | 773-516-4146
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Fax | 773-961-7922
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | STACEY KNOWLES
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Credential | PT
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Telephone | 773-516-4146
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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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