Provider Demographics
NPI:1255759056
Name:FERRIS, STEVEN (PT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:FERRIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 W GRANVILLE AVE
Mailing Address - Street 2:APT 710
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-5046
Mailing Address - Country:US
Mailing Address - Phone:773-965-4890
Mailing Address - Fax:
Practice Address - Street 1:929 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1491
Practice Address - Country:US
Practice Address - Phone:773-965-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.006093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist