OrganizationActive
Athletic Edge Physical Therapy LLC
NPI 1124326038 · Physical Therapy Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1124326038
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Daniel Gray, Ceo(312) 617-5949
- License
- 070015130 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1319 S Michigan Ave
Chicago, IL 60605-2601
Phone: (312) 617-5949
Fax: (312) 447-0036
Approximate (ZIP-level) locationGet directions
Mailing address
1319 S Michigan Ave
Chicago, IL 60605-2601
Registry dates
- Enumerated
- 2011-03-02
- Last updated
- 2011-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.