Dana Christiansen

Individual provider Active NPI Physical Therapist · Marengo, IL

NPI 1124304233 · NPPES record last updated Nov 2, 2011

Key facts

NPI
1124304233
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.017910 (IL)
Practice address
1120 N Taylor St
Marengo, IL 60152-2369
Phone
(847) 613-5806
NPI assigned
Nov 2, 2011
Sex
Female
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
070.017910ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.017910 IL Yes

Addresses

Primary practice location

1120 N Taylor St
Marengo, IL 60152-2369

Mailing address

1120 N Taylor St
Marengo, IL 60152-2369
Phone (847) 613-5806

Other providers in Marengo, IL

All providers in Marengo, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.