Organization
WIEBUSCH PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACI WIEBUSCH HILL MPT (PRESIDENT)
(773) 750-7648
Entity
Organization
Contact information
Practice address
900 N NORTH BRANCH ST, CHICAGO, IL 60622-4278
(773) 750-7648
(773) 327-7470
Mailing address
1701 WEST WRIGHTWOOD AVENUE, CHICAGO, IL 60614-7335
(773) 750-7648
(773) 327-7470
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634891
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/02/2006
Last updated
07/21/2022
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