Provider Demographics
NPI:1407098007
Name:PETER ZEPELAK PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:PETER ZEPELAK PHYSICAL THERAPY PC
Other - Org Name:ZEPELAK PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZEPELAK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:847-277-9698
Mailing Address - Street 1:5039 30TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 EXECUTIVE CT
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9519
Practice Address - Country:US
Practice Address - Phone:847-277-9698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN80652251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285742304OtherPERSONAL NPI
1285742304OtherPERSONAL NPI