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General NPI Number Information
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NPI Number | 1407098007
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Entity Type | Organization
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Legal Business Name | PETER ZEPELAK PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 4 EXECUTIVE CT SUITE 1
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City | SOUTH BARRINGTON
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State | IL
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Zip | 60010-9519
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Country | US
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Telephone | 847-277-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 5039 30TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-1309
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | PETER J ZEPELAK
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Credential | D.P.T.
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Telephone | 847-277-9698
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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 | 8065
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License Number State | MN
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