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General NPI Number Information
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NPI Number | 1356456057
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE THERAPEUTICS, PC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 04/17/2014
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Provider Practice Location Address
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Address Line | 16610 S. 107TH ST
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City | ORLAND PARK
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State | IL
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Zip | 60467-8898
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Country | US
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Telephone | 708-364-7500
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Fax | 708-364-7555
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Provider Business Mailing Address
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Address Line | 16610 S. 107TH ST
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City | ORLAND PARK
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State | IL
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Zip | 60467-8898
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Country | US
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Telephone | 708-364-7500
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Fax | 708-364-7555
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Authorized Official
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Title or Position | OWNER, PRESIDENT.
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Name | TAREK EL-SHIKH
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Credential | PT, DPT
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Telephone | 708-623-4222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 53000087A
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License Number State | IN
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