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Organization
BATSON PEDIATRIC PHYSICAL THERAPY AND SPORT REHABILITATION
Active
Organization
BATSON PEDIATRIC PHYSICAL THERAPY AND SPORT REHABILITATION
Active
Other names
Nicholas A. Batson
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS AVELLINO BATSON P.T. (OWNER/MANAGER)
(847) 254-1708
Entity
Organization
Contact information
Practice address
25753 W IVANHOE RD, WAUCONDA, IL 60084-2366
(847) 254-1708
(847) 487-0759
Mailing address
25753 W IVANHOE RD, WAUCONDA, IL 60084-2366
(847) 254-1708
(847) 487-2285
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
070011615
IL
246Z00000X
Other Specialist/Technologist
213000023
IL
332BC3200X
Customized Equipment (DME)
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110624814001
—
IL
Enumeration date
08/10/2009
Last updated
08/10/2009
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