# MTN PROACTIVE REHAB, LTD.

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

## Provider details

- **NPI number:** 1386188589
- **Authorized official:** DR. PETER ANDREW THOMPSON D.C. (OWNER)
- **Authorized official phone:** (773) 716-9500

## Contact information

- **Practice address:** 5614 S PULASKI RD, CHICAGO, IL 60629-4420
- **Practice address phone:** (773) 716-9500
- **Mailing address:** 630 N FRANKLIN ST APT 801, CHICAGO, IL 60654-8353
- **Mailing address phone:** (773) 716-9500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 038010385 | IL | Yes |

## Other

- **Enumeration date:** 12/07/2016
- **Last updated:** 12/07/2016