# CORE FITNESS AND PT

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

## Provider details

- **NPI number:** 1629326947
- **Authorized official:** DIANE FIDLER (OWNER)
- **Authorized official phone:** (708) 469-7441

## Contact information

- **Practice address:** 6475 JOLIET RD, SUITE C, LA GRANGE HIGHLANDS, IL 60525-4647
- **Practice address phone:** (708) 469-7441
- **Practice address fax:** (708) 469-7661
- **Mailing address:** 6475 JOLIET RD, SUITE C, LA GRANGE HIGHLANDS, IL 60525-4647
- **Mailing address phone:** (708) 469-7441
- **Mailing address fax:** (708) 469-7661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 070008168 | IL | Yes |

## Other

- **Enumeration date:** 08/16/2012
- **Last updated:** 08/16/2012