MEDICARE: HYPERMOBILE DPT, 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	:	1689487456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYPERMOBILE DPT, LLC

Provider Business Mailing Address
First Line	:	1251 N HOYNE AVE APT 217
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-3009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	664 W HUBBARD ST UNIT 200
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5509
Country	:	US
Telephone Number	:	312-971-7279
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAITLIN RICHCREEK
Credential	:	PT, DPT
Telephone Number	:	626-393-3345

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	06/25/2025

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