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WADDELL SPORTS REHAB LLC NPI 1972377273


NPI Information

NPI: 1972377273
Provider Name: WADDELL SPORTS REHAB LLC
Classification: Physical Therapist - 2251S0007X
Entity Type: Organization

Specialization: Sports

Address:
9820 S TRUMBULL AVE
EVERGREEN PARK, IL
ZIP 60805
Phone: (773) 307-7288
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WADDELL SPORTS REHAB LLC is a sports physical therapist in Evergreen Park, IL. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement. WADDELL SPORTS REHAB LLC NPI is 1972377273. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9820 S TRUMBULL AVE
EVERGREEN PARK, IL
ZIP 60805-049
Phone: (773) 307-7288

The provider's authorized official is Robert Martin Waddell .
The authorized official title is Owner and has the following contact phone number (773) 307-7288.

The enumeration date for this NPI number is 11/8/2023 and was last updated on 11/8/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12251S0007XPhysical TherapistSportsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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