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General NPI Number Information
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NPI Number | 1720882152
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Entity Type | Individual
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Provider Name | ASRA MAMSA RAZVI PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 701 W NORTH AVE
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City | MELROSE PARK
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State | IL
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Zip | 60160-1699
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Country | US
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Telephone | 708-681-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 7113 CAMBRIDGE RD
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City | WOODRIDGE
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State | IL
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Zip | 60517-2179
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Country | US
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Telephone | 630-999-7575
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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 | 070028786
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License Number State | IL
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