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General NPI Number Information
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NPI Number | 1841231651
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Entity Type | Organization
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Legal Business Name | STAR PHYSICAL THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 412 63RD ST SUITE 108
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-2000
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Country | US
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Telephone | 630-353-1355
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Fax | 630-353-1356
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Provider Business Mailing Address
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Address Line | 412 63RD ST SUITE 108
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-2000
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Country | US
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Telephone | 630-353-1355
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Fax | 630-353-1356
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELSAYED S HASSANEIN
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Credential | DPT, PT, MSC
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Telephone | 630-353-1355
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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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