Form Physical Therapy, Llc

LBN: Form Physical Therapy, Llc
Form Physical Therapy, Llc is an health care organization with primary practice located at 10356 Roosevelt Rd , Westchester IL 60154. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty. Form Physical Therapy, Llc can be contacted via phone (708) 497-4600, or through Elavia, Kevin via phone (708) 497-4600.

Contact Information

Primary practice address
10356 Roosevelt Rd Westchester IL 60154
Phone: (708) 497-4600
Fax: (708) 497-4601
Website:
Map and Directions
Authorized official contact:
Name: Elavia, Kevin DPT
Phone: (708) 497-4600

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X

Profile Details

NPI number 1700516820
LBN Legal business name Form Physical Therapy, Llc
DBA Doing business as
Authorized official Elavia, Kevin DPT
Entity Organization
Organization subpart 1 No
Enumeration date Jun 13th, 2022
Last updated Jul 26th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers