Provider Demographics
NPI:1821680273
Name:ADVANCED PHYSICAL MEDICINE & THERAPY, LTD.
Entity Type:Organization
Organization Name:ADVANCED PHYSICAL MEDICINE & THERAPY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-222-9060
Mailing Address - Street 1:350 W KENSINGTON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1141
Mailing Address - Country:US
Mailing Address - Phone:847-222-9060
Mailing Address - Fax:847-222-9130
Practice Address - Street 1:350 W KENSINGTON RD STE 102
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1141
Practice Address - Country:US
Practice Address - Phone:847-222-9060
Practice Address - Fax:847-222-9130
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED PHYSICAL MEDICINE & THERAPY, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment