Organization
LIBERTY PHYSICAL THERAPY, PC
Active
Organization
LIBERTY PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHANA A OSMAN PT, MS, OCS (OWNER)
(773) 292-9380
Entity
Organization
Contact information
Practice address
2738 W NORTH AVE, CHICAGO, IL 60647-5247
(773) 292-9380
(773) 292-9381
Mailing address
2738 W NORTH AVE, CHICAGO, IL 60647-5247
(773) 292-9380
(773) 292-9381
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634847
BLUE CROSS BLUE SHIELD
IL
05
—
627364415001
—
IL
01
—
7811632
AETNA
IL
Enumeration date
05/18/2006
Last updated
04/20/2008
Update your record
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