Individual ProviderGrant Ryan KosterPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address6000 W. Touhy, Suite 202, Chicago, IL 60646(773) 774-4291(630) 575-6250PECOS EnrollmentBased on the most recent information from CMS, provider Grant Ryan Koster does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1043289168Provider TypeIndividualFull NameKoster, Grant RyanTitleMr.CredentialPT, MSPT, ATC, CSCSGenderMaleSole ProprietorNoEnumeration Date3/14/2006Last Updated2/24/2017Contact InformationPractice LocationPractice Address6000 W. Touhy, Suite 202, Chicago, IL 60646Phone(773) 774-4291Fax(773) 774-4527Mailing LocationMailing Address625 Enterprise Dr, Oak Brook, IL 60523-8813Phone(630) 575-6250Fax(630) 575-7450Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense070012664IllinoisCode174400000XDescriptionSpecialistOther Service ProvidersLicense096-001522Illinois