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General NPI Number Information
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NPI Number | 1487869848
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Entity Type | Individual
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Provider Name | ALESHA RILEY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 4721 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60640-7553
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Country | US
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Telephone | 773-770-3682
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Fax |
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Provider Business Mailing Address
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Address Line | 2619 W AGATITE AVE APT 1H
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City | CHICAGO
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State | IL
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Zip | 60625-3089
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Country | US
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Telephone | 314-497-8912
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Fax |
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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 | 70015665
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.015665
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License Number State | IL
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