Provider Demographics
NPI:1124631676
Name:LEENA BIRD PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:LEENA BIRD PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-726-2976
Mailing Address - Street 1:400 PRAIRIE KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-4154
Mailing Address - Country:US
Mailing Address - Phone:773-726-2976
Mailing Address - Fax:
Practice Address - Street 1:400 PRAIRIE KNOLL DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-4154
Practice Address - Country:US
Practice Address - Phone:773-726-2976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy