Humphrey, Chad

Humphrey, Chad is an individual health care provider with primary practice located at 850 43Rd Ave Ste 300 , Moline IL 61265-8401. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Humphrey, Chad can be contacted via phone (309) 743-0300.

Contact Information

Primary practice address
850 43Rd Ave Ste 300 Moline IL 61265-8401
Phone: (309) 743-0300
Fax: (309) 743-0318
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070-012365 Illinois

Profile Details

NPI number 1215988795
LBN Legal business name Humphrey, Chad
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Apr 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215988795 NPPES
Illinois Other 070-012365 ILLINOIS PT LICENSE NO.

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