Provider Demographics
NPI:1598204505
Name:CHEBNY SPORTS MEDICINE LLC
Entity Type:Organization
Organization Name:CHEBNY SPORTS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CHEBNY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:224-456-0117
Mailing Address - Street 1:1860 N IL ROUTE 83 STE 116
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7928
Mailing Address - Country:US
Mailing Address - Phone:242-252-2999
Mailing Address - Fax:224-252-2105
Practice Address - Street 1:1860 N IL ROUTE 83 STE 116
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7928
Practice Address - Country:US
Practice Address - Phone:242-252-2999
Practice Address - Fax:224-252-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty