Organization
SOUTHWEST PHYSICAL THERAPY AND REHABILIATION, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M VAIL DPT (PHYSICAL THERAPIST)
(708) 499-4497
Entity
Organization
Contact information
Practice address
111 W. JACKSON STREET, MORRIS, IL 60450-1845
(815) 941-7777
Mailing address
111 W. JACKSON STREET, MORRIS, IL 60450-1845
(815) 941-7777
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
060005170
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618548
BCBS OF ILLINOIS
IL
Enumeration date
12/27/2007
Last updated
04/30/2008
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