Organization
GOODLIFE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRAB MICKEY SHAH PT (PHYSICAL THERAPIST)
(708) 966-4386
Entity
Organization
Contact information
Practice address
16517 106TH CT, ORLAND PARK, IL 60467-4545
(708) 966-4386
(708) 966-4387
Mailing address
9730 S WESTERN AVE, EVERGREEN PARK, IL 60805-2814
(708) 581-9700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-013727
IL
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
12/18/2008
Last updated
08/01/2024
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