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Organization

CONROY SPORTS PHYSICAL THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STEPHEN L CONROY P.T. (OWNER)
(815) 578-9655
Entity
Organization

Contact information

Practice address
319 NORTH FRONT ST, MCHENRY, IL 60050-5504
(815) 578-9655
(815) 578-9642
Mailing address
319 NORTH FRONT ST, MCHENRY, IL 60050-5504
(815) 578-9655
(815) 578-9642

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05632057
BLUECROSS BLUESHIELD
IL
01
05632289
BLUE CROSS BLUE SHIELD
IL
01
601014700
ACS OWCP
IL
01
7515430
AETNA
IL
Enumeration date
03/25/2007
Last updated
05/19/2008
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