Michael J Leitza, PT | |
417 E Il Route 173 Unit 101, Antioch, IL 60002-9407 | |
(800) 974-4378 | |
(630) 515-1536 |
Full Name | Michael J Leitza |
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Gender | Male |
Speciality | Physical Therapist |
Location | 417 E Il Route 173 Unit 101, Antioch, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336185198 | NPI | - | NPPES |
4045700 | Medicaid | WI | |
11791524 | Other | WI | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 10024-24 (Wisconsin) | Secondary |
225100000X | Physical Therapist | 070011119 (Illinois) | Primary |
Provider Name | Dpt Holdings Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1689648602 PECOS PAC ID: 4688679293 Enrollment ID: O20061003000259 |
Mailing Address | Practice Location Address |
---|---|
Michael J Leitza, PT 24014 W Renwick Rd Ste F, Plainfield, IL 60544-8708 Ph: (800) 974-4378 | Michael J Leitza, PT 417 E Il Route 173 Unit 101, Antioch, IL 60002-9407 Ph: (800) 974-4378 |
Daniel F Werner, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 543 Orchard St, Antioch, IL 60002 Phone: 847-239-3565 | |
Mr. Michael W Silenzi, PT, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 543 Orchard Str, Antioch, IL 60002 Phone: 847-395-6100 Fax: 847-395-6162 | |
Ma Gina D Augusto, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1010 Sanderling Ct, Antioch, IL 60002 Phone: 847-395-7973 Fax: 847-395-7973 | |
Mr. Larry V Stone, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 543 Orchard St, Antioch, IL 60002 Phone: 847-395-6100 Fax: 847-395-6162 | |
Mrs. Jill A Stone, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 543 Orchard St, Antioch, IL 60002 Phone: 847-395-6100 Fax: 847-395-6162 | |
Athletico Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1122 Main St., Antioch, IL 60002 Phone: 847-395-0321 Fax: 847-395-0298 |