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General NPI Number Information
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NPI Number | 1568503944
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY PROVIDERS INC.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6222 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60629-4610
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Country | US
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Telephone | 773-581-5000
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Fax | 773-581-7781
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Provider Business Mailing Address
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Address Line | 6222 SOUTH PULASKI ROAD
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City | CHICAGO
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State | IL
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Zip | 60629-4610
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Country | US
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Telephone | 708-229-9828
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Fax | 708-422-0914
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. MASHKOOR ALI KHAN
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Credential |
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Telephone | 773-581-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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