Organization
MTN PROACTIVE REHAB, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER ANDREW THOMPSON D.C. (OWNER)
(773) 716-9500
Entity
Organization
Contact information
Practice address
5614 S PULASKI RD, CHICAGO, IL 60629-4420
(773) 716-9500
Mailing address
630 N FRANKLIN ST APT 801, CHICAGO, IL 60654-8353
(773) 716-9500
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
038010385
IL
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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