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ATHLETIC EDGE PHYSICAL THERAPY LLC NPI 1124326038


NPI Information

NPI: 1124326038
Provider Name: ATHLETIC EDGE PHYSICAL THERAPY LLC
Classification: Clinic/Center - 261QP2000X
Entity Type: Organization

Specialization: Physical Therapy

Address:
1319 S MICHIGAN AVE
CHICAGO, IL
ZIP 60605
Phone: (312) 617-5949
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ATHLETIC EDGE PHYSICAL THERAPY LLC is a physical therapy clinic center in Chicago, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance. ATHLETIC EDGE PHYSICAL THERAPY LLC NPI is 1124326038. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1319 S MICHIGAN AVE
CHICAGO, IL
ZIP 60605-601
Phone: (312) 617-5949
Fax: (312) 447-0036

The provider's authorized official is Daniel L Gray .
The authorized official title is Ceo and has the following contact phone number (312) 617-5949.

The enumeration date for this NPI number is 3/2/2011 and was last updated on 6/6/2011.


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
1225100000XPhysical Therapist070015130ILLINOISNo
2261QP2000XClinic/CenterPhysical Therapy070015130ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PENDINGMEDICARE UPINILLINOIS
2PENDINGMEDICARE OSCAR/CERTIFICATIONILLINOIS

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: 11/14/2023

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