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General NPI Number Information
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NPI Number | 1508194952
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Entity Type | Organization
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Legal Business Name | ALLIED THERAPY NETWORK, INC.
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 1155 N MAIN ST SUITE E
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City | GLENDALE HEIGHTS
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State | IL
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Zip | 60139-3508
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Country | US
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Telephone | 630-858-9000
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Fax | 630-858-2421
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Provider Business Mailing Address
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Address Line | 1155 N MAIN ST STE E
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City | GLENDALE HEIGHTS
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State | IL
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Zip | 60139-3508
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Country | US
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Telephone | 630-858-9000
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Fax | 630-858-2421
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAWRENCE MASICLAT
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Credential |
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Telephone | 630-858-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | IL
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