Organization
WADDELL SPORTS REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MARTIN WADDELL DPT (OWNER)
(773) 307-7288
Entity
Organization
Contact information
Practice address
9820 S TRUMBULL AVE, EVERGREEN PARK, IL 60805-3049
(773) 307-7288
Mailing address
9820 S TRUMBULL AVE, EVERGREEN PARK, IL 60805-3049
(773) 307-7288
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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