Organization
CITY CENTER PHYSICAL THERAPY - JOLIET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY R SEMLOW PT (PHYSICAL THERAPIST)
(815) 722-1757
Entity
Organization
Contact information
Practice address
205 E CLINTON ST, JOLIET, IL 60432-2854
(815) 126-2468
(815) 726-4431
Mailing address
205 E CLINTON ST, JOLIET, IL 60432-2854
(815) 126-2468
(815) 726-4431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932154
BLUE CROSS BLUE SHIELD
IL
05
—
207445
—
IL
01
—
DB8745
RAILROAD MEDICARE
IL
Enumeration date
01/18/2007
Last updated
07/16/2008
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