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Organization
INVICTUS SPORTS MEDICINE LLC
Active
Organization
INVICTUS SPORTS MEDICINE LLC
Active
Other names
Invictus Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMADOR AYALA III DPT (OWNER/PHYSICAL THERAPIST)
(847) 980-6826
Entity
Organization
Contact information
Practice address
28430 N BALLARD DR, LAKE FOREST, IL 60045-4508
(847) 980-6826
Mailing address
1925 S OSPREY LN, LIBERTYVILLE, IL 60048-4873
(847) 980-6826
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-023307
IL
Other
Enumeration date
03/20/2018
Last updated
04/14/2018
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