| Chicago Health And Physical Therapy Center Sc | |
|
5545 W Montrose Ave Chicago IL 60641-1331 | |
| (773) 282-6648 | |
| (773) 282-6965 |
| Full Name | Chicago Health And Physical Therapy Center Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5545 W Montrose Ave, Chicago, Illinois |
| Authorized Official Name and Position | Richard J Dietzen (DIRECTOR) |
| Authorized Official Contact | 7732826648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Health And Physical Therapy Center Sc 5545 W Montrose Ave Chicago IL 60641-1331 Ph: (773) 282-6648 | Chicago Health And Physical Therapy Center Sc 5545 W Montrose Ave Chicago IL 60641-1331 Ph: (773) 282-6648 |
| NPI Number | 1861421950 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 07/30/2019 |
| Medicare PECOS PAC ID | 3870596455 |
|---|---|
| Medicare Enrollment ID | O20060822000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861421950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 042.618903 (Illinois) | Primary |
| Provider Name | Thomas Michael Albert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457465098 PECOS PAC ID: 2860453156 Enrollment ID: I20041020000854 |
| Provider Name | David J Cunningham |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1619081163 PECOS PAC ID: 4183685498 Enrollment ID: I20041020000868 |
| Provider Name | Richard J Dietzen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1376581116 PECOS PAC ID: 3274556352 Enrollment ID: I20060911000516 |
| Provider Name | Anton Dietzen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063659076 PECOS PAC ID: 2163587924 Enrollment ID: I20090211000776 |
| Provider Name | Michael R Koehler |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1649347030 PECOS PAC ID: 1355492406 Enrollment ID: I20090630000551 |
| Provider Name | Kristin R Ballenger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639486657 PECOS PAC ID: 4688847262 Enrollment ID: I20111026000502 |
| Provider Name | Matthew T Clement |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760852560 PECOS PAC ID: 8527491927 Enrollment ID: I20191126002605 |
| Provider Name | Bethany Kalush |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134878473 PECOS PAC ID: 8729466461 Enrollment ID: I20220608000939 |
| Provider Name | Kaley Stokey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790564011 PECOS PAC ID: 9133574908 Enrollment ID: I20231013002310 |
| Provider Name | John Spencer Kingsley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1184494692 PECOS PAC ID: 0941643894 Enrollment ID: I20240207002054 |
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