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General NPI Number Information
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NPI Number | 1205842986
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Entity Type | Organization
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Legal Business Name | OPTIMUM PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 9301 GOLF RD STE 204
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City | DES PLAINES
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State | IL
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Zip | 60016-1667
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Country | US
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Telephone | 847-391-9720
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Fax | 847-391-9721
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Provider Business Mailing Address
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Address Line | 9301 GOLF RD STE 204
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City | DES PLAINES
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State | IL
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Zip | 60016-1667
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Country | US
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Telephone | 847-391-9720
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Fax | 847-391-9721
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Authorized Official
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Title or Position | OWNER
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Name | SNEHAL MEHTA
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Credential | PT
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Telephone | 847-391-9720
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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 | 070011869
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056006131
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070012356
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License Number State | IL
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