Provider Demographics
NPI:1700697729
Name:SUBLIME PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:SUBLIME PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DPT
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:REBISZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:872-350-2374
Mailing Address - Street 1:6354 W GUNNISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2954
Mailing Address - Country:US
Mailing Address - Phone:872-350-2374
Mailing Address - Fax:
Practice Address - Street 1:6354 W GUNNISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2954
Practice Address - Country:US
Practice Address - Phone:872-350-2374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty