# SPORTS AND ORTHO P.C

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

## Provider details

- **NPI number:** 1871640565
- **Authorized official:** DAHLIA FAHMY PT (PRESIDENT/OWNER)
- **Authorized official phone:** (312) 375-5354

## Contact information

- **Practice address:** 412 W 31ST ST, CHICAGO, IL 60616-3116
- **Practice address phone:** (312) 225-3119
- **Practice address fax:** (312) 225-3219
- **Mailing address:** 412 W 31ST ST, CHICAGO, IL 60616-3116
- **Mailing address phone:** (312) 225-3119
- **Mailing address fax:** (312) 225-3219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2251S0007X | Sports Physical Therapist | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 12/24/2023