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General NPI Number Information
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NPI Number | 1295071090
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Entity Type | Organization
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Legal Business Name | JOURNEY PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 12/25/2012
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 2250 W BELMONT AVE UNIT 1W
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City | CHICAGO
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State | IL
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Zip | 60618-6561
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Country | US
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Telephone | 773-883-2337
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Fax | 773-883-2336
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Provider Business Mailing Address
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Address Line | 2754 N HAMPDEN CT UNIT 805
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City | CHICAGO
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State | IL
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Zip | 60614-1651
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Country | US
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Telephone | 224-766-6346
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/PRESIDENT
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Name | DR. PHILIP C LEE
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Credential | PT, DPT, OCS
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Telephone | 224-766-6346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 070.017153
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License Number State | IL
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