1871374801 NPI number — BODY MECHANICS PHYSICAL THERAPY P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871374801 NPI number — BODY MECHANICS PHYSICAL THERAPY P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BODY MECHANICS PHYSICAL THERAPY P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871374801
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1240 DAVEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATAVIA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60510-8622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-765-7487
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24137 111TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPERVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60564-8315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-931-3244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/05/2023

Additional Information

Authorized Official

Authorized Official Last Name:
RIDER
Authorized Official First Name:
FLORENCIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER AND PRESIDENT
Authorized Official Telephone Number:
248-765-7487

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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