Provider Demographics
NPI:1164034658
Name:MPOWER PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:MPOWER PHYSICAL THERAPY PLLC
Other - Org Name:MPOWER PHYSICAL THERAPY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:VIMMI
Authorized Official - Middle Name:KUMARI
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CERT MDT
Authorized Official - Phone:630-728-7176
Mailing Address - Street 1:222 N COLUMBUS DR APT 4102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7967
Mailing Address - Country:US
Mailing Address - Phone:630-728-7176
Mailing Address - Fax:
Practice Address - Street 1:222 N COLUMBUS DR APT 4102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7967
Practice Address - Country:US
Practice Address - Phone:630-728-7176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy