Provider Demographics
NPI:1457423097
Name:PHYSIOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGDORFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:312-933-4887
Mailing Address - Street 1:408 S OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-3876
Mailing Address - Country:US
Mailing Address - Phone:312-933-4887
Mailing Address - Fax:
Practice Address - Street 1:408 S OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-3876
Practice Address - Country:US
Practice Address - Phone:312-933-4887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70015409174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty