Organization
PHYSIOTHERAPY ASSOCIATES
Active
Other names
The Pediatric Place
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W ZIGENFUS JR. (MANAGER OF PAYOR CONTRACTING)
(901) 685-7227
Entity
Organization
Contact information
Practice address
610 S MAPLE AVE STE 3400, OAK PARK, IL 60304-1094
(708) 660-5880
(708) 660-5886
Mailing address
610 S MAPLE AVE STE 3400, OAK PARK, IL 60304-1094
(708) 660-5880
(708) 660-5886
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636250
BCBS OF IL
IL
Enumeration date
11/24/2006
Last updated
08/22/2020
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