Provider Demographics
NPI:1053677898
Name:PHYSICAL SCIENCES INSTITUTE, INC.
Entity Type:Organization
Organization Name:PHYSICAL SCIENCES INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-850-7901
Mailing Address - Street 1:780 BURR OAK DR
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1122
Mailing Address - Country:US
Mailing Address - Phone:630-850-7901
Mailing Address - Fax:630-850-7903
Practice Address - Street 1:780 BURR OAK DR
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1122
Practice Address - Country:US
Practice Address - Phone:630-850-7901
Practice Address - Fax:630-850-7903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700134112251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty