Organization
WEST PHYSICAL THERAPY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A WEST PT (OWNER)
(630) 466-5866
Entity
Organization
Contact information
Practice address
38 S MAIN ST, SUITE A & B, SUGAR GROVE, IL 60554-5031
(630) 466-5866
(630) 466-5869
Mailing address
PO BOX 274, SUGAR GROVE, IL 60554-0274
(630) 466-5866
(630) 466-5869
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
060-008969 70-005680
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04527354
BLUE CROSS BLUE SHIELD
IL
01
—
APPLICATION PENDING
PHCS
IL
Enumeration date
02/13/2006
Last updated
06/19/2008
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