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Organization
PHYSICAL THERAPY CARE
Active
Organization
PHYSICAL THERAPY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. SAMWEEL AKHNOUKH RPT (OWNER)
(708) 425-2345
Entity
Organization
Contact information
Practice address
4400 W 95TH ST, SUITE 404, OAK LAWN, IL 60453-2654
(708) 425-2345
(708) 425-3456
Mailing address
4400 W 95TH ST, SUITE 404, OAK LAWN, IL 60453-2654
(708) 425-2345
(708) 425-3456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
338865266001
—
IL
Enumeration date
03/05/2007
Last updated
08/22/2020
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