Provider Demographics
NPI:1104581289
Name:SEND PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:SEND PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUP
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:815-978-4527
Mailing Address - Street 1:4345 N PAULINA ST # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1219
Mailing Address - Country:US
Mailing Address - Phone:815-978-4527
Mailing Address - Fax:
Practice Address - Street 1:2525 N ELSTON AVE STE C200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2042
Practice Address - Country:US
Practice Address - Phone:815-978-4527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy