Provider Demographics
NPI:1568861714
Name:AMERICAN PHYSICAL REHAB&SPORTS MEDICINE CLINIC, LTD
Entity Type:Organization
Organization Name:AMERICAN PHYSICAL REHAB&SPORTS MEDICINE CLINIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MALHOTRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-244-4181
Mailing Address - Street 1:1783 S WASHINGTON ST
Mailing Address - Street 2:SUITE 119
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2462
Mailing Address - Country:US
Mailing Address - Phone:630-717-6188
Mailing Address - Fax:630-717-8842
Practice Address - Street 1:1783 S WASHINGTON ST
Practice Address - Street 2:SUITE 119
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-2462
Practice Address - Country:US
Practice Address - Phone:630-717-6188
Practice Address - Fax:630-717-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty