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General NPI Number Information
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NPI Number | 1881738060
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Entity Type | Organization
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Legal Business Name | MIDWEST PHYSICAL THERAPY CNTR
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 1990 LARKIN AVE SUITE 1
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City | ELGIN
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State | IL
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Zip | 60123-5827
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Country | US
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Telephone | 847-289-9800
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Fax | 847-289-9804
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Provider Business Mailing Address
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Address Line | 500 PARK BLVD SUITE LL80C
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City | ITASCA
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State | IL
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Zip | 60143-3121
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Country | US
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Telephone | 630-285-8007
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Fax | 630-285-8017
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DEVINDER DEOL
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Credential |
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Telephone | 630-285-8007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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