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General NPI Number Information
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NPI Number | 1952025223
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Entity Type | Individual
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Provider Name | PATRICK WALES
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Gender | Male
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 650 W LAKE COOK RD
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-2082
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Country | US
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Telephone | 224-541-9100
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Fax | 773-967-1112
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-890-5900
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Fax | 847-390-4757
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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 | 070027028
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License Number State | IL
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