Provider Demographics
NPI:1104432251
Name:ILLINOIS THERAPY STAFFING LTD
Entity type:Organization
Organization Name:ILLINOIS THERAPY STAFFING LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:847-809-7378
Mailing Address - Street 1:3633 W LAKE AVE STE LL4
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5804
Mailing Address - Country:US
Mailing Address - Phone:847-809-7378
Mailing Address - Fax:
Practice Address - Street 1:3633 W LAKE AVE STE LL4
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5804
Practice Address - Country:US
Practice Address - Phone:847-809-7378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy