Organization
ACTIVA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK PAULSON (PRESIDENT)
(773) 807-3517
Entity
Organization
Contact information
Practice address
2720 S RIVER RD, SUITE 18, DES PLAINES, IL 60018-4106
(773) 807-3517
(847) 297-7970
Mailing address
2720 S RIVER RD, SUITE 18, DES PLAINES, IL 60018-4106
(773) 807-3517
(847) 297-7970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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