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General NPI Number Information
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NPI Number | 1649150350
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Entity Type | Individual
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Provider Name | MR. JUSTIN HARPER PARRIS
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Gender | Male
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 331 W SURF ST STE 6400
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City | CHICAGO
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State | IL
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Zip | 60657-7227
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Country | US
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Telephone | 773-665-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 839 W DIVERSEY PKWY APT 205
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City | CHICAGO
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State | IL
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Zip | 60614-1401
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Country | US
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Telephone | 954-803-8401
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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 | 070.028486
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License Number State | FL
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