| Organization Name: | FUNCTIONAL PHYSICAL THERAPY, INC |
| NPI Number: | 1790738409 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM FRANCIS FEDORSKI (PRESIDENT/OWNER) |
| Mailing Address: | 369 W Army Trail Rd Unit 14 Bloomingdale |
| State: | IL US |
| Postal Code: | 601082358 |
| Phone Number: | 6308935534 |
| Fax Number: | 6308935527 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 07/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070-011136 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| 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 |