Basic Information
Provider Information
NPI: 1386381598
EntityType: 2
ReplacementNPI:  
OrganizationName: OASIS THERAPY SERVICES LLC
LastName:  
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Mailing Information
Address1: 8170 MCCORMICK BLVD STE 112
Address2:  
City: SKOKIE
State: IL
PostalCode: 600762914
CountryCode: US
TelephoneNumber: 7738253336
FaxNumber:  
Practice Location
Address1: 631 HAZEL ST
Address2:  
City: OSHKOSH
State: WI
PostalCode: 549014600
CountryCode: US
TelephoneNumber: 9203939998
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2022
LastUpdateDate: 05/18/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: STESEL
AuthorizedOfficialFirstName: MAXIM
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AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 7738253336
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 05/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QP2000X  Y Ambulatory Health Care FacilitiesClinic/CenterPhysical Therapy

No ID Information.


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