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NPI Code Detail

MEDICARE: CONROY SPORTS PHYSICAL THERAPY LLC

MEDICARE: CONROY SPORTS 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
1261QP2000XPhysical Therapy Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
105632057OTHERILBLUECROSS BLUESHIELD
2601014700OTHERILACS OWCP
37515430OTHERILAETNA
405632289OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1598882391
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONROY SPORTS PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 319 NORTH FRONT ST
Second Line :
City : MCHENRY
State : IL
Zip : 60050-5504
Country : US
Telephone Number : 815-578-9655
Fax Number : 815-578-9642
Provider Business Practice Location Address
First Line : 319 NORTH FRONT ST
Second Line :
City : MCHENRY
State : IL
Zip : 60050-5504
Country : US
Telephone Number : 815-578-9655
Fax Number : 815-578-9642
Authorized Official
Title or Position : OWNER
Name : MR. STEPHEN L CONROY
Credential : P.T.
Telephone Number : 815-578-9655
Provider Enumeration Date : 03/25/2007
Last Update Date : 05/19/2008

Similar Medicare Providers

1245412741 — MRS. JULIE A CONROY P.T.
Practice Location Address:
319 FRONT ST
MCHENRY, IL
60050-5504
Practice Phone: 815-578-9655
Practice Fax: 815-578-9642
1144402645 — MR. STEPHEN L CONROY P.T.
Practice Location Address:
319 FRONT ST
MCHENRY, IL
60050-5504
Practice Phone: 815-578-9655
Practice Fax: 815-578-9642
1821270331 — KATHLEEN M BOEHMER P.T.A.
Practice Location Address:
319 FRONT ST
MCHENRY, IL
60050-5504
Practice Phone: 815-578-9655
Practice Fax: 815-578-9642
1013199520 — PETER DIONELA P.T.
Practice Location Address:
319 FRONT ST
MCHENRY, IL
60050-5504
Practice Phone: 815-578-9655
Practice Fax: 815-578-9642
1730361114 — MARY MATTHIESEN P.T.
Practice Location Address:
319 FRONT ST
MCHENRY, IL
60050-5504
Practice Phone: 815-578-9655
Practice Fax: 815-578-9642
1881276426 — MR. PATRICK JORDAN FINN
Practice Location Address:
333 FRONT ST
MCHENRY, IL
60050-5504
Practice Phone: 815-578-9655
Practice Fax:

Directions to “CONROY SPORTS PHYSICAL THERAPY LLC ” Practice Location

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