Provider Demographics
NPI:1780715128
Name:PHYSICAL THERAPY CHICAGO, LTD
Entity type:Organization
Organization Name:PHYSICAL THERAPY CHICAGO, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GNOLFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-855-1711
Mailing Address - Street 1:25 E WASHINGTON ST
Mailing Address - Street 2:1310
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1708
Mailing Address - Country:US
Mailing Address - Phone:312-855-1711
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST
Practice Address - Street 2:1310
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:312-855-1711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID940060Medicare ID - Type Unspecified