Provider Demographics
NPI:1689964066
Name:PREMIER THERAPY, LLC
Entity Type:Organization
Organization Name:PREMIER THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CINDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-920-4670
Mailing Address - Street 1:361 S FRONTAGE RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5830
Mailing Address - Country:US
Mailing Address - Phone:630-920-4670
Mailing Address - Fax:630-920-4687
Practice Address - Street 1:5252 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2448
Practice Address - Country:US
Practice Address - Phone:773-878-7909
Practice Address - Fax:773-878-8071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty