Provider Demographics
NPI:1053565192
Name:ADVANCED PHYSIOTHERAPY INC
Entity type:Organization
Organization Name:ADVANCED PHYSIOTHERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IZABELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-525-4640
Mailing Address - Street 1:8751 WATERFRONT DR APT 2B
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-3143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11240 S WESTERN AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4116
Practice Address - Country:US
Practice Address - Phone:773-779-1111
Practice Address - Fax:773-779-1525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.009084261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy