Provider Demographics
NPI:1578837795
Name:WORKMENS COMPENSATION & PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:WORKMENS COMPENSATION & PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZBIGNIEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WISNIEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:777-779-1111
Mailing Address - Street 1:PO BOX 744
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60454-0744
Mailing Address - Country:US
Mailing Address - Phone:773-735-1111
Mailing Address - Fax:
Practice Address - Street 1:11240 S WESTERN AVE
Practice Address - Street 2:STE 4
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4116
Practice Address - Country:US
Practice Address - Phone:773-779-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty