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General NPI Number Information
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NPI Number | 1396227302
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Entity Type | Organization
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Legal Business Name | UNIVERSAL PHYSICAL THERAPY PROVIDERS, INC
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/16/2018
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Provider Practice Location Address
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Address Line | 1886 TECHNY CT
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City | NORTHBROOK
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State | IL
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Zip | 60062-5474
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Country | US
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Telephone | 847-707-3779
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Fax | 847-919-6794
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Provider Business Mailing Address
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Address Line | 1886 TECHNY CT
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City | NORTHBROOK
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State | IL
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Zip | 60062-5474
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Country | US
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Telephone | 847-707-3779
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Fax | 847-919-6794
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Authorized Official
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Title or Position | SECRETARY
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Name | JOLYNETTE ILAGAN
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Credential | PT
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Telephone | 773-931-5926
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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 |
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License Number State |
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