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General NPI Number Information
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NPI Number | 1922999655
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Entity Type | Organization
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Legal Business Name | ECLIPSE SPORTS REHAB AND PERFORMANCE
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 108 N STATE ST FL 4
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City | CHICAGO
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State | IL
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Zip | 60602
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Country | US
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Telephone | 574-303-8988
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Fax |
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Provider Business Mailing Address
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Address Line | 1638 N MARSHFIELD AVE APT 2F
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City | CHICAGO
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State | IL
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Zip | 60622-1430
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Country | US
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Telephone | 574-303-8988
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST / OWNER
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Name | KEVIN ACKERMANN
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Credential | PT, DPT
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Telephone | 574-303-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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