| Entity Name: | FORM PHYSICAL THERAPY LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Reinstated |
| Date Formed: | 12 May 2022 |
| Company Number: | LLC_11812821 |
| File Number: | 11812821 |
| Type of Management: | Manager Managed |
| Date Status Change: | 22 Jan 2025 |
| Address | 10356 ROOSEVELT RD, WESTCHESTER, 60154, IL |
| Place of Formation: | ILLINOIS |
| Name and Address | Role | Appointment Date |
|---|---|---|
| KEVIN ELAVIA, 10356 W ROOSEVELT RD, WESTCHESTER, 60154 | Agent | 2025-01-22 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| KEVIN ELAVIA, 1314 IVY CT, WESTMONT, IL, 60559 | Manager | 2025-01-22 |
Date of last update: 03 Feb 2025
