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NPI Code Detail

MEDICARE: THERASYS, INC.

MEDICARE: THERASYS, INC.
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1811991235
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERASYS, INC.
Provider Business Mailing Address
First Line : 5005 NEWPORT DR
Second Line : STE 401
City : ROLLING MEADOWS
State : IL
Zip : 60008-3840
Country : US
Telephone Number : 847-797-1050
Fax Number : 847-797-1337
Provider Business Practice Location Address
First Line : 1400 W NORTHWEST HWY
Second Line :
City : PALATINE
State : IL
Zip : 60067-1837
Country : US
Telephone Number : 847-358-2225
Fax Number : 847-358-8354
Authorized Official
Title or Position : CHAIRMAN OF THE BOARD
Name : MR. WALTER G. CORNETT III
Credential : MBA
Telephone Number : 847-631-6235
Provider Enumeration Date : 06/13/2005
Last Update Date : 08/22/2020

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