# ANDERSONVILLE PHYSICAL THERAPY, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043368731
- **Authorized official:** JOSEPH YERGA PT, DPT (OWNER, PRESIDENT)
- **Authorized official phone:** (773) 907-3599

## Contact information

- **Practice address:** 5414 N BROADWAY ST, CHICAGO, IL 60640-1704
- **Practice address phone:** (773) 907-3599
- **Practice address fax:** (773) 907-3510
- **Mailing address:** 5414 N BROADWAY ST, CHICAGO, IL 60640-1704
- **Mailing address phone:** (773) 907-3599
- **Mailing address fax:** (773) 907-3510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 070008600 | IL | Yes |
| 225100000X | Physical Therapist | — | IL | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 08/12/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1623236 | BCBS | IL |
| 01 | — | 600037500 | US DEPT OF LABOR | IL |
| 01 | — | 650021537 | RAILROAD MEDICARE | IL |