Provider Demographics
NPI:1477752301
Name:ELEVATE PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:ELEVATE PHYSICAL THERAPY INC.
Other - Org Name:BODY WERKS PHYSICAL THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:GINSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:847-323-1156
Mailing Address - Street 1:1429 N CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4434
Mailing Address - Country:US
Mailing Address - Phone:847-323-1156
Mailing Address - Fax:
Practice Address - Street 1:147 W RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3142
Practice Address - Country:US
Practice Address - Phone:847-749-4509
Practice Address - Fax:847-749-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210826Medicare PIN