Basic Information
| Provider Information | |||||||||
| NPI: | 1649602640 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PROFESSIONAL THERAPEUTICS LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14711 S RAVINIA AVE | ||||||||
| Address2: | |||||||||
| City: | ORLAND PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604623100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082269200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 14711 S RAVINIA AVE | ||||||||
| Address2: | |||||||||
| City: | ORLAND PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604623100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082269200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2013 | ||||||||
| LastUpdateDate: | 08/01/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GEIGER | ||||||||
| AuthorizedOfficialFirstName: | SARAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OTR/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7082269200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | OTR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.