Robert S Ahlgren, PTA

Individual provider Active NPI Physical Therapy Assistant · Wood Dale, IL

NPI 1346474236 · NPPES record last updated May 7, 2009

Key facts

NPI
1346474236
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160003121 (IL)
Practice address
387 Spruce Rd
Wood Dale, IL 60191-2544
Phone
(603) 616-1776
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
160003121ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160003121 IL Yes

Addresses

Primary practice location

387 Spruce Rd
Wood Dale, IL 60191-2544

Mailing address

387 Spruce Rd
Wood Dale, IL 60191-2544

Other providers in Wood Dale, IL

All providers in Wood Dale, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.