# AMANDA RAFFERTY DPT LLC

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

## Provider details

- **NPI number:** 1447907670
- **Authorized official:** AMANDA RAFFERTY PT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (773) 835-9072

## Contact information

- **Practice address:** 36 MAIN ST STE 100, PARK RIDGE, IL 60068-4059
- **Practice address phone:** (773) 835-9072
- **Mailing address:** 1712 S VINE AVE, PARK RIDGE, IL 60068-5421
- **Mailing address phone:** (773) 835-9072

## Taxonomy

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

## Other

- **Enumeration date:** 03/08/2022
- **Last updated:** 01/23/2024