Provider Demographics
NPI:1467814921
Name:KORE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:KORE PHYSICAL THERAPY, LLC
Other - Org Name:KORE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-961-0066
Mailing Address - Street 1:23 N LINCOLN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3436
Mailing Address - Country:US
Mailing Address - Phone:847-961-0066
Mailing Address - Fax:
Practice Address - Street 1:23 N LINCOLN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3436
Practice Address - Country:US
Practice Address - Phone:847-961-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty