Provider Demographics
NPI:1457231904
Name:ABUNDANT HEALTH PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:ABUNDANT HEALTH PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:773-896-8178
Mailing Address - Street 1:155 N BERTEAU AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2926
Mailing Address - Country:US
Mailing Address - Phone:773-896-8178
Mailing Address - Fax:
Practice Address - Street 1:110 E SCHILLER ST STE 307
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2823
Practice Address - Country:US
Practice Address - Phone:773-896-8178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy