Provider Demographics
NPI:1235598012
Name:PEAK PHYSICAL THERAPY CLINIC LLC
Entity Type:Organization
Organization Name:PEAK PHYSICAL THERAPY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:IGYARTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-393-4691
Mailing Address - Street 1:1111 N PLAZA DR
Mailing Address - Street 2:SUITE 706
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-6021
Mailing Address - Country:US
Mailing Address - Phone:847-393-4501
Mailing Address - Fax:
Practice Address - Street 1:455 E GRAND RIVER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1551
Practice Address - Country:US
Practice Address - Phone:810-360-0806
Practice Address - Fax:844-809-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty