Provider Demographics
NPI:1811991235
Name:THERASYS, INC.
Entity type:Organization
Organization Name:THERASYS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:G
Authorized Official - Last Name:CORNETT
Authorized Official - Suffix:III
Authorized Official - Credentials:MBA
Authorized Official - Phone:847-631-6235
Mailing Address - Street 1:5005 NEWPORT DR
Mailing Address - Street 2:STE 401
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3840
Mailing Address - Country:US
Mailing Address - Phone:847-797-1050
Mailing Address - Fax:847-797-1337
Practice Address - Street 1:1400 W NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-1837
Practice Address - Country:US
Practice Address - Phone:847-358-2225
Practice Address - Fax:847-358-8354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty