Organization
MID AMERICAN PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATEF SALAMA PHYSICAL THERAPIST (PRRESIDENT)
(773) 297-2894
Entity
Organization
Contact information
Practice address
9830 RIDGELAND AVE, CHICAGO RIDGE, IL 60415-2667
(708) 422-8150
(708) 422-8160
Mailing address
9830 RIDGELAND AVE, CHICAGO RIDGE, IL 60415-2667
(708) 422-8150
(708) 422-8160
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
IL
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922159128
NPI
IL
01
—
1952452195
NPI
IL
01
—
1972672640
NPI
IL
Enumeration date
04/14/2007
Last updated
08/22/2020
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