Provider Demographics
NPI:1033448360
Name:EXCELLCARE PHYSICAL THERAPY & REHABILITATION NETWORK 2 INC
Entity Type:Organization
Organization Name:EXCELLCARE PHYSICAL THERAPY & REHABILITATION NETWORK 2 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARADZIEJ
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:773-313-3711
Mailing Address - Street 1:6508 W ARCHER AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2423
Mailing Address - Country:US
Mailing Address - Phone:773-313-3711
Mailing Address - Fax:773-313-3714
Practice Address - Street 1:6508 W ARCHER AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2423
Practice Address - Country:US
Practice Address - Phone:773-313-3711
Practice Address - Fax:773-313-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy