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General NPI Number Information
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NPI Number | 1225547045
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Entity Type | Organization
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Legal Business Name | LINK PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 528 KEDZIE ST
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City | EVANSTON
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State | IL
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Zip | 60202-2306
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Country | US
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Telephone | 773-791-5969
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Fax | 847-905-0218
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Provider Business Mailing Address
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Address Line | 528 KEDZIE ST
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City | EVANSTON
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State | IL
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Zip | 60202-2306
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Country | US
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Telephone | 847-868-8396
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Fax | 847-905-0218
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Authorized Official
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Title or Position | OWNER
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Name | SUZANNE ACERON BADILLO
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Credential | PT
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Telephone | 847-868-8396
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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 | 070011033
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License Number State | IL
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Taxonomy #2
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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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