Organization
LIFESPORT PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON WILLIAMS PT (PRESIDENT)
(312) 330-1607
Entity
Organization
Contact information
Practice address
2000 N RACINE AVE, CHICAGO, IL 60614-7006
(312) 330-1607
Mailing address
135 MONTGOMERY LN, GLENVIEW, IL 60025-4924
(312) 330-1607
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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