Organization
HEALING WALLS REHABILITATION LLC
Active
Other names
Healing Walls Rehabilitation LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAKECIA SHANTEL LEAVY PT, DPT (OWNER/PHYSICAL THERAPIST)
(217) 766-3569
Entity
Organization
Contact information
Practice address
12905 S MAY ST, CALUMET PARK, IL 60827-6562
(217) 766-3569
(708) 842-2004
Mailing address
12905 S MAY ST, CALUMET PARK, IL 60827-6562
(217) 766-3569
(708) 842-2004
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
070018779
IL
Other
Enumeration date
08/24/2016
Last updated
10/20/2016
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