Premium Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PREMIUM PHYSICAL THERAPY

Practice address

17901 Governors Hwy
Suite 204
Homewood, IL 60430-1144

Phone

(708) 957-3300

Fax

(708) 957-3385

NPI assigned

Jan 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Eyaema Ekeng Aanamndu

Title

Executive Director

Phone

(708) 957-3300

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497809818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17065 DIXIE HWY",
            "address_2": "SUITE 24",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291376",
            "telephone_number": "708-957-3300",
            "fax_number": "708-957-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 204",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-957-3300",
            "fax_number": "708-957-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AANAMNDU",
        "authorized_official_first_name": "EYAEMA",
        "authorized_official_middle_name": "EKENG",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-957-3300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Popp Family Chiropractic P C
• Joan G Porche, PHD
• Constance D Porter
• Jadyn Powell-Cork
• Cicely D Powell, LCSW
• Prestige Healthcare Services of Illinois
• Beth Simon Price
• Priority One Healthcare LLC
• Professional Accounts Receivable Management Team (Cognitive Counseling Center)
• Progressive Therapeutic Services

• Physical Therapy Clinic/Center in Homewood, IL
• Providers in Homewood, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.