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General NPI Number Information
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NPI Number | 1457894743
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Entity Type | Organization
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Legal Business Name | KIDS FIRST PHYSICAL THERAPY CORPORATION
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 4734 N ARTESIAN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2902
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Country | US
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Telephone | 773-851-9197
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Fax | 773-219-2478
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Provider Business Mailing Address
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Address Line | 4734 N ARTESIAN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2902
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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 | PHYSICAL THERAPIST
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Name | SANDRA BARLOW
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Credential | M.P.T, D.P.T.
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Telephone | 773-851-9197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 070.013454
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License Number State | IL
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