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Organization
MIDWEST SPORTS MEDICINE & ORTHOPEDIC SURGICAL SPECIALISTS, LTD
Active
Organization
MIDWEST SPORTS MEDICINE & ORTHOPEDIC SURGICAL SPECIALISTS, LTD
Active
Other names
The Center for Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY A MARTIN (DIRECTOR)
(847) 437-9889
Entity
Organization
Contact information
Practice address
975 E NERGE RD, SUITE N140, ROSELLE, IL 60172-4804
(847) 944-1230
(847) 944-1240
Mailing address
975 E NERGE RD, SUITE N140, ROSELLE, IL 60172-4804
(847) 944-1230
(847) 944-1240
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31603457
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/16/2007
Last updated
08/22/2020
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