Provider Demographics
NPI:1750619805
Name:BUSKIRK PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:BUSKIRK PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:BUSKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, SCS
Authorized Official - Phone:847-251-2028
Mailing Address - Street 1:3545 LAKE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1058
Mailing Address - Country:US
Mailing Address - Phone:847-251-2028
Mailing Address - Fax:847-512-5064
Practice Address - Street 1:7830 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE C15
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2432
Practice Address - Country:US
Practice Address - Phone:301-951-5936
Practice Address - Fax:301-951-5937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty