Provider Demographics
NPI:1134397763
Name:PROFESSIONAL THERAPY CONSULTANTS, INC.
Entity type:Organization
Organization Name:PROFESSIONAL THERAPY CONSULTANTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOS
Authorized Official - Middle Name:G
Authorized Official - Last Name:DORRRESTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, PT
Authorized Official - Phone:630-917-2050
Mailing Address - Street 1:14111 S NAPERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-3329
Mailing Address - Country:US
Mailing Address - Phone:815-436-4828
Mailing Address - Fax:815-254-7057
Practice Address - Street 1:29 S WEBSTER ST
Practice Address - Street 2:SUITE 270
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5356
Practice Address - Country:US
Practice Address - Phone:630-917-2050
Practice Address - Fax:815-254-7057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-17
Last Update Date:2008-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-0003923261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy