Provider Demographics
NPI:1164746558
Name:DX MEDICAL AND PHYSICAL THERAPY CLINIC LTD
Entity Type:Organization
Organization Name:DX MEDICAL AND PHYSICAL THERAPY CLINIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RENLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:XIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-452-5500
Mailing Address - Street 1:7601 W MONTROSE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-1000
Mailing Address - Country:US
Mailing Address - Phone:708-452-5500
Mailing Address - Fax:708-452-5547
Practice Address - Street 1:7601 W MONTROSE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-1000
Practice Address - Country:US
Practice Address - Phone:708-452-5500
Practice Address - Fax:708-452-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty