Provider Demographics
NPI:1205221124
Name:HOLISTIC SCIENCE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:HOLISTIC SCIENCE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-725-7200
Mailing Address - Street 1:101 N 129TH INFANTRY DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5135
Mailing Address - Country:US
Mailing Address - Phone:815-725-7200
Mailing Address - Fax:815-725-7258
Practice Address - Street 1:101 N 129TH INFANTRY DR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5135
Practice Address - Country:US
Practice Address - Phone:815-725-7200
Practice Address - Fax:815-725-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2081P2900X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty