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General NPI Number Information
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NPI Number | 1306114699
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Entity Type | Organization
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Legal Business Name | TELOS THERAPY, LLC
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 651 W WASHINGTON BLVD STE 305
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City | CHICAGO
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State | IL
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Zip | 60661
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Country | US
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Telephone | 312-880-9355
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Fax | 312-470-6550
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Provider Business Mailing Address
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Address Line | 651 W WASHINGTON BLVD STE 305
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City | CHICAGO
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State | IL
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Zip | 60661-2137
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Country | US
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Telephone | 312-404-1548
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Fax | 312-470-6550
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | STEFANY A SARELAS
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Credential | PT
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Telephone | 312-404-1548
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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 | 070013614
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License Number State | IL
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