Provider Demographics
NPI:1558390849
Name:PEAK THERAPEUTICS, LTD
Entity Type:Organization
Organization Name:PEAK THERAPEUTICS, LTD
Other - Org Name:PEAK AND BALANCE CENTERS OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:BUSKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-906-2025
Mailing Address - Street 1:3545 LAKE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1058
Mailing Address - Country:US
Mailing Address - Phone:847-906-2025
Mailing Address - Fax:847-512-5064
Practice Address - Street 1:3545 LAKE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1058
Practice Address - Country:US
Practice Address - Phone:847-906-2025
Practice Address - Fax:847-512-5064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060004284174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634372OtherBCBS GROUP NO.
IL200573902OtherTRANSIT REHABILITATION CENTERS OF CHICAGO
IL1618443OtherBCBS GROUP NO.
IL236963283001Medicaid
ILDC3951OtherMEDICARE RAILROAD-PALMETTO GBA
IL200573902OtherTRANSIT REHABILITATION CENTERS OF CHICAGO
ILDC3951OtherMEDICARE RAILROAD-PALMETTO GBA