Provider Demographics
NPI:1437164019
Name:AMERICAN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:AMERICAN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NIVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERGES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:219-736-9169
Mailing Address - Street 1:9010 DOUBLETREE DR S
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307
Mailing Address - Country:US
Mailing Address - Phone:219-736-9169
Mailing Address - Fax:219-736-9167
Practice Address - Street 1:303 W 89TH AVE
Practice Address - Street 2:SUITE E3
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410
Practice Address - Country:US
Practice Address - Phone:219-736-9169
Practice Address - Fax:219-736-9167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008020A225100000X
IN05008044A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN233850Medicare ID - Type Unspecified