Eric Bellm, DPT

Individual provider Active NPI Physical Therapist · Winnetka, IL

NPI 1114213196 · NPPES record last updated Jan 29, 2013

Key facts

NPI
1114213196
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070-019688 (IL)
Practice address
852 Green Bay Rd
Winnetka, IL 60093-1853
Phone
(847) 441-5788
Fax
(847) 784-8720
NPI assigned
Jun 28, 2011
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070-019688ILMDPhysical Therapist
2011019590MOMDSports Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 2011019590 MO
Physical Therapist 225100000X 070-019688 IL Yes

Addresses

Primary practice location

852 Green Bay Rd
Winnetka, IL 60093-1853

Mailing address

852 Green Bay Rd
Winnetka, IL 60093-1853
Phone (847) 441-5788

Other providers in Winnetka, IL

All providers in Winnetka, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.