Organization
PROFESSIONAL PHYSICAL THERAPY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTY M. OLOFSSON O.T.R., P.T.A. (VICE PRESIDENT)
(773) 779-7273
Entity
Organization
Contact information
Practice address
10201 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 779-7273
(773) 779-7298
Mailing address
10201 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 779-7273
(773) 779-7298
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070000479
IL
225100000X
Physical Therapist
070012996
IL
225200000X
Physical Therapy Assistant
160004410
IL
225X00000X
Occupational Therapist
Primary
056002420
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618872
BC BS OF IL
IL
01
—
650004791
R.R. MEDICARE
IL
Enumeration date
06/29/2007
Last updated
03/04/2010
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