Organization
FUNDAMENTAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA BOYNEWICZ PT (OWNER)
(773) 991-9953
Entity
Organization
Contact information
Practice address
3721 N RICHMOND ST, CHICAGO, IL 60618-3524
(773) 991-9953
(773) 478-9245
Mailing address
3721 N. RICHMOND, CHICAGO, IL 60618
(773) 991-9953
(773) 478-9245
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
070012672
IL
Other
Enumeration date
07/11/2011
Last updated
07/11/2011
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