Provider Demographics
NPI:1851621601
Name:ORTHOPEDIC PHYSICAL THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC PHYSICAL THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:708-301-2255
Mailing Address - Street 1:12261 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-7847
Mailing Address - Country:US
Mailing Address - Phone:708-301-2255
Mailing Address - Fax:708-301-2631
Practice Address - Street 1:12261 W 159TH ST
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-7847
Practice Address - Country:US
Practice Address - Phone:708-301-2255
Practice Address - Fax:708-301-2631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070002519261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy