Provider Demographics
NPI:1053503268
Name:FITSJOY THERAPY, LLC
Entity Type:Organization
Organization Name:FITSJOY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:773-983-8470
Mailing Address - Street 1:1264 W WINONA ST
Mailing Address - Street 2:3A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2937
Mailing Address - Country:US
Mailing Address - Phone:773-334-5654
Mailing Address - Fax:
Practice Address - Street 1:5906 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5420
Practice Address - Country:US
Practice Address - Phone:773-774-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-11
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy