MEDICARE: MUSCLE & JOINT PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1336760602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSCLE & JOINT PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	3228 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1602
Country	:	US
Telephone Number	:	773-857-0689
Fax Number	:	773-857-0769

Provider Business Practice Location Address
First Line	:	3228 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1602
Country	:	US
Telephone Number	:	773-857-0689
Fax Number	:	773-857-0769

Authorized Official
Title or Position	:	OWNER/PT
Name	:	MATTHEW CARL JOHNSON
Credential	:	DPT
Telephone Number	:	773-857-0689

Provider Enumeration Date	:	04/28/2020
Last Update Date	:	07/13/2023

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