MEDICARE: FUNCTION1ST 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	070011147	IL

General Provider Information

NPI Number	:	1770873945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUNCTION1ST PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2433
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60078-2433
Country	:	US
Telephone Number	:	847-370-5600
Fax Number	:	866-787-3422

Provider Business Practice Location Address
First Line	:	7421 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-2139
Country	:	US
Telephone Number	:	847-370-5600
Fax Number	:	866-788-4922

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. DESI 'AL' FLORES
Credential	:	P.T.
Telephone Number	:	847-370-5600

Provider Enumeration Date	:	04/08/2011
Last Update Date	:	06/17/2026

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