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General NPI Number Information
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NPI Number | 1720112931
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Entity Type | Organization
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Legal Business Name | PHYSIOTHERAPY ASSOCIATES HOME REHABILITATION, LLC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 610 S MAPLE AVE SUITE 3400
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City | OAK PARK
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State | IL
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Zip | 60304-1091
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Country | US
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Telephone | 708-358-9911
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Fax | 708-358-9922
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Provider Business Mailing Address
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Address Line | 610 S MAPLE AVE SUITE 3400
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City | OAK PARK
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State | IL
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Zip | 60304-1091
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Country | US
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Telephone | 708-358-9911
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Fax | 708-358-9922
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Authorized Official
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Title or Position | REGIONAL BUSINESS MGR
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Name | MR. ROBERT L PEREZ
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Credential |
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Telephone | 404-556-5932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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