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NPI Code Detail

MEDICARE: LIBERTY PHYSICAL THERAPY, PC

MEDICARE: LIBERTY PHYSICAL THERAPY, PC
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
12251X0800XOrthopedic Physical TherapistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101634847OTHERILBLUE CROSS BLUE SHIELD
27811632OTHERILAETNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710930383
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIBERTY PHYSICAL THERAPY, PC
Provider Business Mailing Address
First Line : 2738 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5247
Country : US
Telephone Number : 773-292-9380
Fax Number : 773-292-9381
Provider Business Practice Location Address
First Line : 2738 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5247
Country : US
Telephone Number : 773-292-9380
Fax Number : 773-292-9381
Authorized Official
Title or Position : OWNER
Name : MEHANA A OSMAN
Credential : PT, MS, OCS
Telephone Number : 773-292-9380
Provider Enumeration Date : 05/18/2006
Last Update Date : 04/20/2008

Similar Medicare Providers

1811696172 — KIM TAPIAWALA DDS
Practice Location Address:
2750 W NORTH AVE
CHICAGO, IL
60647-5247
Practice Phone: 312-666-3494
Practice Fax:
1750335006 — MEHANA A OSMAN PT, MS, OCS
Practice Location Address:
2738 W NORTH AVE
CHICAGO, IL
60647-5247
Practice Phone: 773-292-9380
Practice Fax: 773-292-9381
1770530503 — SHERRY KAYE NORDSTROM MD
Practice Location Address:
2750 W NORTH AVE
CHICAGO, IL
60647-5247
Practice Phone: 312-666-3494
Practice Fax:
1326065871 — CHARLES HARRIS M.D.
Practice Location Address:
2750 W NORTH AVE
CHICAGO, IL
60647-5247
Practice Phone: 312-666-3494
Practice Fax:
1831110006 — DR. GHASSAN SOURI D.D.S.
Practice Location Address:
2750 W NORTH AVE
CHICAGO, IL
60647-5247
Practice Phone: 312-432-4541
Practice Fax: 773-342-3204
1689780769 — DR. DEBORAH ELIZABETH MIDGLEY M.D.
Practice Location Address:
2750 W NORTH AVE
CHICAGO, IL
60647-5247
Practice Phone: 312-666-3494
Practice Fax: 773-276-0749

Directions to “LIBERTY PHYSICAL THERAPY, PC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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