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General NPI Number Information
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NPI Number | 1477724631
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Entity Type | Individual
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Provider Name | THEMI JOURAS PT
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Gender | Male
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 4114 SW HIGHWAY
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City | HOMETOWN
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State | IL
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Zip | 60456
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Country | US
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Telephone | 708-424-4047
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Fax | 708-424-4591
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Provider Business Mailing Address
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Address Line | 4004 W 111TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-5703
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Country | US
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Telephone | 708-424-4047
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Fax | 708-424-4591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070006524
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License Number State | IL
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