Organization Name: | MID AMERICAN PHYSICAL THERAPY PC |
NPI Number: | 1568687705 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ATEF SALAMA (PRRESIDENT) |
Mailing Address: | 9830 Ridgeland Ave Chicago Ridge |
State: | IL US |
Postal Code: | 604152667 |
Phone Number: | 7084228150 |
Fax Number: | 7084228160 |
NPI Enumeration Date: | 04/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |