=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164556080
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PREFERRED THERAPEUTIC SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2007
-----------------------------------------------------
Last Update Date | 07/23/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6918 ELEANOR PL
-----------------------------------------------------
City | DARIEN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60561-3949
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-370-9725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6918 ELEANOR PL
-----------------------------------------------------
City | DARIEN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60561-3949
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-370-9725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST
-----------------------------------------------------
Name | TALHA SHAMSI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 773-370-9725
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------