MEDICARE: COMPLETE PHYSICAL THERAPY CENTER 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1467297309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE PHYSICAL THERAPY CENTER LLC

Provider Business Mailing Address
First Line	:	4941 ROSE AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-3202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5021 CHASE AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-4014
Country	:	US
Telephone Number	:	630-929-5377
Fax Number	:	630-929-0891

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DANIELLE YENTER
Credential	:	PT
Telephone Number	:	312-909-9525

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	11/21/2024

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