Provider Demographics
NPI:1811903628
Name:ANAND PHYSICAL THERAPY & REHABILITATION LTD
Entity type:Organization
Organization Name:ANAND PHYSICAL THERAPY & REHABILITATION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHINI
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:630-437-5175
Mailing Address - Street 1:6800 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3493
Mailing Address - Country:US
Mailing Address - Phone:630-437-5175
Mailing Address - Fax:630-437-5174
Practice Address - Street 1:6800 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3493
Practice Address - Country:US
Practice Address - Phone:630-437-5175
Practice Address - Fax:630-437-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010481174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232180OtherBC/BS PROVIDER #
IL354626763001Medicaid
IL202979Medicare ID - Type UnspecifiedMEDICARE PROVIDER #