Provider Demographics
NPI:1669691440
Name:LIBERTY PHYSICAL THERAPY CENTER
Entity type:Organization
Organization Name:LIBERTY PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:EL SAYED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-222-8870
Mailing Address - Street 1:4550 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-1842
Mailing Address - Country:US
Mailing Address - Phone:708-222-8870
Mailing Address - Fax:708-222-8871
Practice Address - Street 1:4550 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-1842
Practice Address - Country:US
Practice Address - Phone:708-229-8688
Practice Address - Fax:708-229-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy