Provider Demographics
NPI:1417070780
Name:BACK IN ACTION NAPERVILLE
Entity Type:Organization
Organization Name:BACK IN ACTION NAPERVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-357-9061
Mailing Address - Street 1:888 SOUTH ROUTE 59
Mailing Address - Street 2:SUITE 140
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-0962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:888 SOUTH ROUTE 59
Practice Address - Street 2:SUITE 140
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-0962
Practice Address - Country:US
Practice Address - Phone:630-357-9061
Practice Address - Fax:630-357-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK21858Medicare ID - Type Unspecified