Provider Demographics
NPI:1063891240
Name:CENTER FOR PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:CENTER FOR PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:DANICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURIC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:773-827-2355
Mailing Address - Street 1:1800 DEWES ST STE B
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4377
Mailing Address - Country:US
Mailing Address - Phone:847-920-7887
Mailing Address - Fax:847-423-6190
Practice Address - Street 1:1800 DEWES ST STE B
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4377
Practice Address - Country:US
Practice Address - Phone:847-920-7887
Practice Address - Fax:847-423-6190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
IL070021324174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty