| Organization Name: | PRO SPORTS AND SPINAL REHAB |
| NPI Number: | 1770905432 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RANDAL CYBULSKI (OWNER) |
| Mailing Address: | 12337 S Route 59 Unit 119 Plainfield |
| State: | IL US |
| Postal Code: | 605854625 |
| Phone Number: | 8152676263 |
| Fax Number: | 8157828549 |
| NPI Enumeration Date: | 01/15/2014 |
| NPI Last Update Date: | 03/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070006640 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |