Provider Demographics
NPI:1326385477
Name:ENTROPY PHYSIOTHERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:ENTROPY PHYSIOTHERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, WCS
Authorized Official - Phone:773-747-4070
Mailing Address - Street 1:1925 N CLYBOURN AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4946
Mailing Address - Country:US
Mailing Address - Phone:773-747-4070
Mailing Address - Fax:
Practice Address - Street 1:1925 N CLYBOURN AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4946
Practice Address - Country:US
Practice Address - Phone:773-747-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL40976785261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy