Provider Demographics
NPI:1346417193
Name:ACTIVE PHYSICAL THERAPY & REHABILITATION P.C.
Entity Type:Organization
Organization Name:ACTIVE PHYSICAL THERAPY & REHABILITATION P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:EL SAYED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-336-9067
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0278
Mailing Address - Country:US
Mailing Address - Phone:708-336-9067
Mailing Address - Fax:708-226-4897
Practice Address - Street 1:14200 S 88TH AVE
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4287
Practice Address - Country:US
Practice Address - Phone:708-336-9067
Practice Address - Fax:708-226-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-007900261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy