Provider Demographics
NPI:1346264629
Name:OXFORD PROGRESSIVE THERAPY SERVICES
Entity Type:Organization
Organization Name:OXFORD PROGRESSIVE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:OXFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:618-382-3755
Mailing Address - Street 1:108 APRIL AVE
Mailing Address - Street 2:
Mailing Address - City:CARMI
Mailing Address - State:IL
Mailing Address - Zip Code:62821-1577
Mailing Address - Country:US
Mailing Address - Phone:618-382-3755
Mailing Address - Fax:618-382-2377
Practice Address - Street 1:108 APRIL AVE
Practice Address - Street 2:
Practice Address - City:CARMI
Practice Address - State:IL
Practice Address - Zip Code:62821-1577
Practice Address - Country:US
Practice Address - Phone:618-382-3755
Practice Address - Fax:618-382-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL205 126Medicare ID - Type Unspecified