Humphrey, Chad
Humphrey, Chad is an individual health care provider with primary practice located at 850 43Rd Ave Ste 300 , Moline IL 61265-8401. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Humphrey, Chad can be contacted via phone (309) 743-0300.Contact Information
Primary practice address
850 43Rd Ave Ste 300
Moline IL 61265-8401
Phone: (309) 743-0300
Fax: (309) 743-0318
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 070-012365 | Illinois |
Profile Details
| NPI number | 1215988795 |
|---|---|
| LBN Legal business name | Humphrey, Chad |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Apr 11th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215988795 | NPPES |
| Illinois | Other | 070-012365 | ILLINOIS PT LICENSE NO. |
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