Danielle M Adolph, DPT

Individual provider Active NPI Physical Therapist · Minooka, IL

NPI 1295929396 · NPPES record last updated Aug 13, 2014

Key facts

NPI
1295929396
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070-015921 (IL)
Practice address
2081 Ridge Rd
Suite 101
Minooka, IL 60447-8848
Phone
(815) 467-1612
NPI assigned
Aug 31, 2007
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
070-015921ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-015921 IL Yes

Addresses

Primary practice location

2081 Ridge Rd
Suite 101
Minooka, IL 60447-8848

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers

IdentifierTypeStateIssuer
P01048510OtherILMEDICARE RAILROAD
P01328076OtherILRAILROAD MEDICARE

Other names

  • Danielle M Devicchio Former name

Other providers in Minooka, IL

All providers in Minooka, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.