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General NPI Number Information
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NPI Number | 1578837795
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Entity Type | Organization
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Legal Business Name | WORKMENS COMPENSATION & PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 11240 S WESTERN AVE STE 4
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City | CHICAGO
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State | IL
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Zip | 60643-4116
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Country | US
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Telephone | 773-779-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 744
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City | OAK LAWN
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State | IL
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Zip | 60454-0744
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Country | US
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Telephone | 773-735-1111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZBIGNIEW WISNIEWSKI
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Credential |
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Telephone | 777-779-1111
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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 |
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License Number State |
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