Provider Demographics
NPI:1730234121
Name:WOMEN'S PHYSICAL THERAPY INSTITUTE INC.
Entity type:Organization
Organization Name:WOMEN'S PHYSICAL THERAPY INSTITUTE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ELLIOTT-BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MHS
Authorized Official - Phone:847-550-9784
Mailing Address - Street 1:755 ELA RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2337
Mailing Address - Country:US
Mailing Address - Phone:847-550-9784
Mailing Address - Fax:847-550-9780
Practice Address - Street 1:755 ELA RD
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2337
Practice Address - Country:US
Practice Address - Phone:847-550-9784
Practice Address - Fax:847-550-9780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04925901OtherBCBS PROVIDER #
IL208478Medicare ID - Type UnspecifiedMEDICARE GRP PROVIDER #