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General NPI Number Information
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NPI Number | 1669915674
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Entity Type | Organization
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Legal Business Name | ANNA'S PEDIATRIC PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 11/22/2016
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 2120 W ARMITAGE AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60647-4516
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Country | US
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Telephone | 630-930-9851
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Fax | 872-806-0916
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Provider Business Mailing Address
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Address Line | 2120 W ARMITAGE AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60647-4516
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Country | US
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Telephone | 630-930-9851
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Fax | 872-806-0916
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANNA ELYSE JESS
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Credential | P.T.
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Telephone | 630-930-9851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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