Organization
MIDWEST PHYSICAL THERAPY CNTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVINDER DEOL (PRACTICE ADMINISTRATOR)
(630) 285-8007
Entity
Organization
Contact information
Practice address
1990 LARKIN AVE, SUITE 1, ELGIN, IL 60123-5827
(847) 289-9800
(847) 289-9804
Mailing address
500 PARK BLVD, SUITE LL80C, ITASCA, IL 60143-3121
(630) 285-8007
(630) 285-8017
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621171
BCBS PROVIDER NUMBER
IL
Enumeration date
02/19/2007
Last updated
08/18/2008
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