Provider Demographics
NPI:1891363917
Name:HOME THERAPY SPECIALISTS, P.D.
Entity Type:Organization
Organization Name:HOME THERAPY SPECIALISTS, P.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KOOYENGA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-372-2784
Mailing Address - Street 1:16544 PARLIAMENT AVENUE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2464
Mailing Address - Country:US
Mailing Address - Phone:708-372-2784
Mailing Address - Fax:708-235-0145
Practice Address - Street 1:16544 PARLIAMENT AVENUE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2464
Practice Address - Country:US
Practice Address - Phone:708-372-2784
Practice Address - Fax:708-235-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomicsGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty