Provider Demographics
NPI:1982725750
Name:CONROY ORTHOPAEDIC & SPORTS PHYSICAL THERAPY LTD
Entity type:Organization
Organization Name:CONROY ORTHOPAEDIC & SPORTS PHYSICAL THERAPY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-957-0095
Mailing Address - Street 1:2920 W. 183RD ST
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2868
Mailing Address - Country:US
Mailing Address - Phone:708-957-0095
Mailing Address - Fax:708-957-0096
Practice Address - Street 1:2920 W. 183RD ST
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2868
Practice Address - Country:US
Practice Address - Phone:708-957-0095
Practice Address - Fax:708-957-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1617574OtherBCBS