Rhett Enriquez Banzon, PT
Individual provider Active NPI Physical Therapist · Chicago, IL
NPI 1679741995 · NPPES record last updated Dec 12, 2008
Key facts
- NPI
- 1679741995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070011345 (IL)
- Practice address
- 5946 N Milwaukee Ave
Chicago, IL 60646-5424 - Phone
- (773) 775-6637
- Fax
- (773) 775-6638
- NPI assigned
- Feb 20, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070011345 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Therapy Specialists, L.L.C. | Physical Therapist | Past | Accepting new patients |
| Integrated Therapy Specialists, L.L.C. | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070011345 | IL | Yes |
Addresses
Primary practice location
5946 N Milwaukee Ave
Chicago, IL 60646-5424
Mailing address
5946 N Milwaukee Ave
Chicago, IL 60646-5424
Phone (773) 775-6637
Other providers in Chicago, IL
- Bryan Banuelos Ramirez
- Cesiah Banuelos
- Daniel Carlos Banuelos
- Nuvia Banuelos
- Eleanor Resane Banzon
- Theresa Banzuela
- Benjamin A. Baptist
- Brian D Baptist
- Guilherme Baptista de Faria
- Jacqueline A Baptista
All providers in Chicago, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.