| Brian So, | |
|
909 Davis St, Suite 220, Evanston, IL 60201-3683 | |
| (847) 733-7906 | |
| (847) 733-8405 |
| Full Name | Brian So |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 909 Davis St, Evanston, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588086805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070-020486 (Illinois) | Primary |
| Provider Name | Athletic And Therapeutic Institute Of Naperville, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1023129681 PECOS PAC ID: 8325014020 Enrollment ID: O20040903000494 |
| Provider Name | Athletico Ltd |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1821085028 PECOS PAC ID: 4789602681 Enrollment ID: O20120612000342 |
| Mailing Address | Practice Location Address |
|---|---|
| Brian So, 909 Davis St, Suite 220, Evanston, IL 60201-3683 Ph: (847) 733-7906 | Brian So, 909 Davis St, Suite 220, Evanston, IL 60201-3683 Ph: (847) 733-7906 |
Ryan Perry, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1115 Emerson St, Evanston, IL 60201 Phone: 847-570-9861 | |
Ms. Teresa Maciejczyk, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1729 Benson Ave, Evanston, IL 60201 Phone: 847-570-7170 Fax: 847-570-7172 | |
Lee Davimes, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1629 Chicago Ave, Evanston, IL 60201 Phone: 847-475-1630 Fax: 847-475-1631 | |
Aimee Jane Aledia Pena, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 Asbury Ave, Evanston, IL 60202 Phone: 847-316-3320 | |
Aime Maranan, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 839 Dodge Ave, Evanston, IL 60202 Phone: 847-859-6384 | |
Patricia Simmons Anderson, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1024 Cleveland St, Evanston, IL 60202 Phone: 847-328-2405 Fax: 847-864-7806 | |
Kellie Audra Banfield, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 805 Davis St, Evanston, IL 60201 Phone: 847-864-1535 Fax: 847-864-1537 |