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General NPI Number Information
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NPI Number | 1538613674
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Entity Type | Organization
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Legal Business Name | CATALYST PHYSIOTHERAPY, PERFORMANCE, & WELLNESS LLC
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 710 E RAILROAD ST
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City | SANDWICH
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State | IL
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Zip | 60548
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Country | US
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Telephone | 815-313-6333
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Fax | 815-417-6921
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Provider Business Mailing Address
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Address Line | 710 E RAILROAD ST
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City | SANDWICH
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State | IL
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Zip | 60548-2250
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Country | US
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Telephone | 815-313-6333
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Fax | 815-417-6921
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Authorized Official
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Title or Position | CO - OWNER PHYSICAL THERAPIST
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Name | DR. SARAH GREENHAGEN
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Credential | D.P.T., G.C.S.
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Telephone | 815-793-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 070010389
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 070020085
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License Number State | IL
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