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General NPI Number Information
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NPI Number | 1154436459
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY NETWORK PC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 5725 S ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-1617
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Country | US
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Telephone | 773-526-5130
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 388316
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City | CHICAGO
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State | IL
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Zip | 60638-8316
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Country | US
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Telephone | 773-526-5130
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANUSZ PARZUCH
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Credential |
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Telephone | 773-526-5129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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