# ADVANTAGE PHYSICAL THERAPY ASSOCIATES, SC

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

## Provider details

- **NPI number:** 1164680492
- **Authorized official:** JAMES A DALLAS LPT (PRESIDENT)
- **Authorized official phone:** (630) 792-9790

## Contact information

- **Practice address:** 6234 MAIN ST, DOWNERS GROVE, IL 60516-1908
- **Practice address phone:** (630) 960-9914
- **Mailing address:** PO BOX 72180, ROSELLE, IL 60172-0180
- **Mailing address phone:** (630) 792-9790
- **Mailing address fax:** (630) 792-9794

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 070-002882 | IL | Yes |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 03/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1164680492 | BLUE CROSS BLUE SHIELD | IL |