Provider Demographics
NPI:1821188160
Name:PEDIATRIC THERAPY SERVICES LTD
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY SERVICES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NOOTBAAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT PCS
Authorized Official - Phone:847-913-9311
Mailing Address - Street 1:1572 BUNESCU LANE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1250
Mailing Address - Country:US
Mailing Address - Phone:847-913-9311
Mailing Address - Fax:
Practice Address - Street 1:1572 BUNESCU LANE
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1250
Practice Address - Country:US
Practice Address - Phone:847-913-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty