# CORE SPORT & PHYSICAL THERAPY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CORE FITNESS & PHYSICAL THERAPY INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376375394
- **Legal business name:** CORE FITNESS & PHYSICAL THERAPY INC.
- **Authorized official:** DIANE FIDLER PHYSICAL THERAPIST (OWNER)
- **Authorized official phone:** (773) 510-6422

## Contact information

- **Practice address:** 10224 S KEDZIE AVE UNIT C, EVERGREEN PARK, IL 60805-3735
- **Practice address phone:** (773) 941-6132
- **Mailing address:** 2940 W 95TH ST, EVERGREEN PARK, IL 60805-2408
- **Mailing address phone:** (708) 422-0990
- **Mailing address fax:** (708) 741-3029

## Taxonomy

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

## Other

- **Enumeration date:** 08/19/2024
- **Last updated:** 09/26/2025