Organization
MATT AMBROSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT AMBROSE (OWNER)
(630) 269-1630
Entity
Organization
Contact information
Practice address
1016 W LAKE ST UNIT 2, CHICAGO, IL 60607-1715
(630) 269-1630
Mailing address
520 N KINGSBURY ST UNIT 701, CHICAGO, IL 60654-8767
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
11/19/2024
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