Provider Demographics
NPI:1700245487
Name:THE FIT INSTITUTE
Entity Type:Organization
Organization Name:THE FIT INSTITUTE
Other - Org Name:THE FIT INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:773-844-0240
Mailing Address - Street 1:2500 W BRADLEY PL
Mailing Address - Street 2:UNIT F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4702
Mailing Address - Country:US
Mailing Address - Phone:773-799-2795
Mailing Address - Fax:
Practice Address - Street 1:2500 W BRADLEY PL
Practice Address - Street 2:UNIT F
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4702
Practice Address - Country:US
Practice Address - Phone:773-799-2795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12537972OtherCAQH