Provider Demographics
NPI:1023400074
Name:WEST TOWN PHYSICAL THERAPY LTD.
Entity Type:Organization
Organization Name:WEST TOWN PHYSICAL THERAPY LTD.
Other - Org Name:WEST TOWN CHICAGO PHYSICAL THERAPY LTD.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:773-805-0248
Mailing Address - Street 1:859 N ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5148
Mailing Address - Country:US
Mailing Address - Phone:773-729-2551
Mailing Address - Fax:773-729-2556
Practice Address - Street 1:859 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5148
Practice Address - Country:US
Practice Address - Phone:773-729-2551
Practice Address - Fax:773-729-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-28
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014334261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy