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Organization
THERAPY PROVIDERS SOUTH INC.
Active
Organization
THERAPY PROVIDERS SOUTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASHKOOR ALI KHAN (EXECUTIVE)
(708) 229-0081
Entity
Organization
Contact information
Practice address
18636 DIXIE HWY, THERAPY PROVIDERS SOUTH, HOMEWOOD, IL 60430-3741
(708) 922-0400
(708) 922-0330
Mailing address
18636 DIXIE HWY, THERAPY PROVIDERS SOUTH BUSINESS OFFICE, HOMEWOOD, IL 60430-3741
(708) 922-0400
(708) 229-0084
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1636510
BCBS
IL
01
—
611221200
OWCP DEPT OF LABOR
IL
Enumeration date
02/12/2007
Last updated
01/19/2026
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