Organization
RELIVE PHYSICAL THERAPY INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES D JUDGE (OWNER)
(708) 903-3362
Entity
Organization
Contact information
Practice address
11360 BROADWAY, CROWN POINT, IN 46307-7197
(708) 390-3362
(708) 390-4430
Mailing address
19070 EVERETT BLVD UNIT 204, MOKENA, IL 60448-2073
(708) 790-3362
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202102051459916
STATE LICENSE
IN
01
—
7083903362
PHONE
IN
Enumeration date
02/25/2021
Last updated
10/09/2024
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