Individual ProviderAmy Therese ClysdalePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address5669 N Northwest Hwy, Chicago, IL 60646-6153(773) 467-5669(651) 308-6084PECOS EnrollmentBased on the most recent information from CMS, provider Amy Therese Clysdale 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 yesterday at 7:33 AM.Profile DetailsProvider ID1508539768Provider TypeIndividualFull NameClysdale, Amy ThereseCredentialPT, DPTGenderFemaleSole ProprietorNoEnumeration Date7/25/2021Last Updated7/27/2021Contact InformationPractice LocationPractice Address5669 N Northwest Hwy, Chicago, IL 60646-6153Phone(773) 467-5669Fax(773) 631-2926Mailing LocationMailing Address1006 W Dakin St Apt 3, Chicago, IL 60613-0170Phone(651) 308-6084FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense070.025949Illinois