Provider Demographics
NPI:1134676786
Name:CADENCE PHYSICAL THERAPY CO
Entity Type:Organization
Organization Name:CADENCE PHYSICAL THERAPY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-691-0962
Mailing Address - Street 1:1691 WEILAND RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6887
Mailing Address - Country:US
Mailing Address - Phone:847-691-0962
Mailing Address - Fax:
Practice Address - Street 1:1300 BUSCH PKWY
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-4505
Practice Address - Country:US
Practice Address - Phone:847-378-4970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty