North Shore Brain And Body INC
Physical Therapist in Libertyville, IL. Organization (NPI-2).
NPI number1053908673
StatusActive
Last updated in NPPESDec 29, 2020
Details
- NPI
- 1053908673
- Entity type
- Organization (NPI-2)
- Legal business name
- North Shore Brain And Body INC
- Organization subpart
- No
- Enumeration date
- Dec 29, 2020
- Certification date
- Dec 29, 2020
- Last updated
- Dec 29, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
1590 S Milwaukee Ave Ste 211Libertyville, IL 60048-3785
Phone 224-688-7710
Mailing address
926 Clark DrGurnee, IL 60031-3115
Phone 224-688-7710
Authorized official
Cathleen Ellen Bender
Owner
2246887710
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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