Organization
MALDONADO O'CONNELL LTD.
Active
Other names
Elite Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS A MALDONADO P.T. (PRESIDENT)
(312) 360-0702
Entity
Organization
Contact information
Practice address
1455 S MICHIGAN AVE, STE. 230, CHICAGO, IL 60605-2771
(312) 360-0702
(312) 360-0705
Mailing address
1455 S MICHIGAN AVE, STE. 230, CHICAGO, IL 60605-2771
(312) 360-0702
(312) 360-0705
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633141
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/26/2007
Last updated
09/19/2007
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