Provider Demographics
NPI:1508037896
Name:METRIX ILLINOIS, INC.
Entity Type:Organization
Organization Name:METRIX ILLINOIS, INC.
Other - Org Name:ORLAND PARK PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TWADDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-328-6775
Mailing Address - Street 1:790 FRONTAGE RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1204
Mailing Address - Country:US
Mailing Address - Phone:847-328-6775
Mailing Address - Fax:
Practice Address - Street 1:10751 163RD PL
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8861
Practice Address - Country:US
Practice Address - Phone:708-349-3377
Practice Address - Fax:708-349-7430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01638048OtherBCBS OF ILLINOIS GROUP #
IL215726Medicare PIN