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SOUTH LOOP PEDIATRIC THERAPY LLC NPI 1356677462


NPI Information

NPI: 1356677462
Provider Name: SOUTH LOOP PEDIATRIC THERAPY LLC
Classification: Physical Therapist - 2251P0200X
Entity Type: Organization

Specialization: Pediatrics

CLIA Number: 14D1081844

Address:
1515 S PRAIRIE AVE
UNIT 603
CHICAGO, IL
ZIP 60605
Phone: (773) 733-1695
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SOUTH LOOP PEDIATRIC THERAPY LLC is a pediatrics physical therapist in Chicago, IL. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given. SOUTH LOOP PEDIATRIC THERAPY LLC NPI is 1356677462. The provider is registered as an organization entity type.

The provider's business location address is:

1515 S PRAIRIE AVE
UNIT 603
CHICAGO, IL
ZIP 60605-043
Phone: (773) 733-1695
Fax: (773) 435-6595

The provider's authorized official is Jana Marlene Susie .
The authorized official title is Physical Therapist and has the following contact phone number (773) 733-1695.

The CLIA number assigned to this NPI record is 14D1081844 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2009 and was last updated on 10/23/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1252Y00000XEarly Intervention Provider Agency070.013558ILLINOISNo
22251P0200XPhysical TherapistPediatrics070.013558ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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