Provider Demographics
NPI:1649558305
Name:RESULTS PHYSICAL THERAPY & FITNESS LLC
Entity Type:Organization
Organization Name:RESULTS PHYSICAL THERAPY & FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSCATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-634-3048
Mailing Address - Street 1:312 N STERLING ST.
Mailing Address - Street 2:
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364
Mailing Address - Country:US
Mailing Address - Phone:815-672-5500
Mailing Address - Fax:815-672-5400
Practice Address - Street 1:312 N STERLING ST
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364-2370
Practice Address - Country:US
Practice Address - Phone:815-672-5500
Practice Address - Fax:815-672-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070013720305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization