Provider Demographics
NPI:1104954429
Name:HIGHLAND PHYSICAL THERAPY,PC
Entity type:Organization
Organization Name:HIGHLAND PHYSICAL THERAPY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEDHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:BADR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-479-6522
Mailing Address - Street 1:1701 CATON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-5635
Mailing Address - Country:US
Mailing Address - Phone:773-616-9893
Mailing Address - Fax:
Practice Address - Street 1:8046 S COTTAGE GROVE AVE STE 106
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-4004
Practice Address - Country:US
Practice Address - Phone:773-616-9893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty