Provider Demographics
NPI:1225596364
Name:LINTAKAS, RIMA (DPT)
Entity Type:Individual
Prefix:
First Name:RIMA
Middle Name:
Last Name:LINTAKAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 ROSEMEAR AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-1736
Mailing Address - Country:US
Mailing Address - Phone:708-648-0008
Mailing Address - Fax:
Practice Address - Street 1:422 N NORTHWEST HWY STE 210
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3273
Practice Address - Country:US
Practice Address - Phone:847-699-9757
Practice Address - Fax:847-696-3626
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL070024180225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program