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Organization
SOUTHWEST PHYSICAL THERAPY AND REHABILITATION, LTD
Active
Organization
SOUTHWEST PHYSICAL THERAPY AND REHABILITATION, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M VAIL DPT (PHYSICAL THERAPIST)
(708) 499-4497
Entity
Organization
Contact information
Practice address
18210 LA GRANGE RD, SUITE 100, TINLEY PARK, IL 60477-7722
(708) 478-7177
(708) 478-7377
Mailing address
18210 LA GRANGE RD, SUITE 100, TINLEY PARK, IL 60477-7722
(708) 478-7177
(708) 478-7377
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
060005170
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618548
BCBS PROVIDER NUMBER
IL
Enumeration date
03/20/2007
Last updated
04/30/2008
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