Organization
GENESIS PHYSICAL THERAPY LLC
Active
Parent organization
GENESIS ORTHOPEDICS & SPORTS MEDICINE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS ORTHOPEDICS & SPORTS MEDICINE LLC
Authorized official
MR. ANDREW SHADID (CEO)
(630) 377-1188
Entity
Organization
Contact information
Practice address
2900 FOXFIELD RD STE 102, ST CHARLES, IL 60174-5799
(630) 377-1188
(630) 377-7360
Mailing address
2900 FOXFIELD RD STE 102, ST CHARLES, IL 60174-5799
(630) 377-1188
(630) 377-7360
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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