Provider Demographics
NPI:1245276146
Name:INTEGRITY PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:INTEGRITY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICEDR
Authorized Official - Prefix:
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLECK-POOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-467-8705
Mailing Address - Street 1:2300 COIT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3769
Mailing Address - Country:US
Mailing Address - Phone:469-467-8705
Mailing Address - Fax:267-321-2550
Practice Address - Street 1:20 S CLARK ST
Practice Address - Street 2:11TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-1882
Practice Address - Country:US
Practice Address - Phone:312-977-1708
Practice Address - Fax:312-977-1709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146692Medicare Oscar/Certification