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General NPI Number Information
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NPI Number | 1467884007
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Entity Type | Organization
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Legal Business Name | CHICAGO PHYSICAL THERAPY & REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 08/03/2017
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Provider Practice Location Address
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Address Line | 30 S MICHIGAN AVE STE 402
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City | CHICAGO
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State | IL
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Zip | 60603-3211
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Country | US
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Telephone | 312-726-1353
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Fax | 312-726-5238
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Provider Business Mailing Address
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Address Line | 30 S MICHIGAN AVE STE 402
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City | CHICAGO
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State | IL
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Zip | 60603-3211
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Country | US
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Telephone | 312-726-1353
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Fax | 312-726-5238
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHRISTY TATARA
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Credential |
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Telephone | 312-726-1353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 070010447
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License Number State | IL
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