PHOENIX UNDERGROUND PHYSICAL THERAPY LLC


Address: 1142 W North Shore Ave Apt 3n, Chicago, IL 60626-4640
Phone: 6082176841

PHOENIX UNDERGROUND PHYSICAL THERAPY LLC (NPI# 1811358849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811358849
Entity Type Organization
Organization Name PHOENIX UNDERGROUND PHYSICAL THERAPY LLC
Practice Address 1142 W North Shore Ave Apt 3n
Chicago
IL 60626-4640
Practice Telephone 6082176841
Mailing Telephone 6082176841
Enumeration Date 2016-03-18
Last Update Date 2016-03-18
Authorized Official Name MATTHEW MCGUIRE (OWNER)
Authorized Official Telephone 6082176841
Authorized Official Credential DPT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2000X Clinic/Center
Specialization: Physical Therapy
070018695 IL Ambulatory Health Care Facilities

Office Location

Street Address 1142 W NORTH SHORE AVE APT 3N
City CHICAGO
State IL
Zip Code 60626-4640

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1891203477 Natalie Cerda Specialist/Technologist 6526 North Winthrop, Chicago, IL 60626 2018-01-17
1841709136 Jennifer Browse Speech-Language Pathologist 7101 N. Greenview, Chicago, IL 60626 2017-09-29
1922526292 Bill Johnson Psychologist 1712 W Estes Avenue Unit 109, Chicago, IL 60626 2017-09-06
1326580333 Zackary Charles Davis Specialist/Technologist 6526 N. Winthrop Avenue, Chicago, IL 60626 2016-11-08
1053772913 Devon Migues Counselor 6710 N Hermitage Ave, 1, Chicago, IL 60626 2016-03-18
1457718124 Carol L. Marshall Social Worker 7231 1/2 N. Sheridan Rd, Chicago, IL 60626 2016-01-26
1972948206 Donna Darcell Smith Counselor 1401 West Jarvis Ave., #2e, Chicago, IL 60626 2013-04-30
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Taxonomy Information

Taxonomy Code 261QP2000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Physical Therapy

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1093324345 Motogenix Concierge Physical Therapy Clinic/Center 111 S Morgan St Apt 620, Chicago, IL 60607-2732 2020-07-23
1275152746 Freeform Physical Therapy LLC Clinic/Center 2906 W Fullerton Ave, Chicago, IL 60647-2921 2020-04-14
1730736158 Achieve Performance Lab LLC Clinic/Center 1940 W Lawrence Ave Apt 3w, Chicago, IL 60640-4012 2019-08-20
1255997862 Urban Physical Therapy LLC Clinic/Center 345 E Ohio St Apt 2807, Chicago, IL 60611-4065 2019-05-20
1760047179 Remedy Physical Therapy and Wellness Clinic/Center 4636 N Kenmore Ave # 2, Chicago, IL 60640-5039 2019-05-01
1780248864 Customfit Concierge Medicine, Health and Fitness LLC Clinic/Center 1413 W Fillmore St Apt 2, Chicago, IL 60607-4716 2019-04-24
1801356175 Kinetic Care Physical Therapy LLC Clinic/Center 3245 N Ashland Ave Apt 2a, Chicago, IL 60657-4087 2019-03-22
1760952626 Prep Performance Center, LLC Clinic/Center 4022 N Rockwell Street, Chicago, IL 60618 2018-12-04
1699272864 Athletico, Ltd. Clinic/Center 2520 N Elston Ave, Chicago, IL 60647-2004 2018-04-12
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City CHICAGO
Zip Code 60626

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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