Organization
BACK IN MOTION PHYSICAL THERAPY & SPINE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONIA M KWAPISINSKI DC (OWNER)
(815) 675-0699
Entity
Organization
Contact information
Practice address
2900 N US HIGHWAY 12 STE J, SPRING GROVE, IL 60081-8322
(815) 675-0699
(815) 675-0689
Mailing address
PO BOX 362, 2900 US HWY 12 SUITE J, SPRING GROVE, IL 60081-0362
(815) 675-0699
(815) 675-0689
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
IL
225100000X
Physical Therapist
Primary
70015875
IL
225100000X
Physical Therapist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05632004
BLUE CROSS BLUE SHIELD
IL
01
—
1437205325
INDIVIDUAL NPI OF LPT
IL
01
—
1730371915
INDIVIDUAL NPI OF DPT
IL
01
—
1932214665
INDIVIDUAL NPI
IL
Enumeration date
04/13/2007
Last updated
03/04/2008
Update your record
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