Provider Demographics
NPI:1003164906
Name:ANOINTED HANDS PHYSICAL THERAPY AND FITNESS CENTER
Entity Type:Organization
Organization Name:ANOINTED HANDS PHYSICAL THERAPY AND FITNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:773-941-9245
Mailing Address - Street 1:1316 N CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1160
Mailing Address - Country:US
Mailing Address - Phone:773-941-9245
Mailing Address - Fax:
Practice Address - Street 1:1316 N CEDAR RD
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1160
Practice Address - Country:US
Practice Address - Phone:773-941-9245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208100000X, 2081P2900X
IL070015850261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL8606OtherMEDICARE