Diane Marola Bullock

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160003333 Issued in IL

Practice address

1200 S York St
Elmhurst, IL 60126-5626

Phone

(630) 646-1141

NPI assigned

Mar 17, 2008

Last updated

Jun 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1669643714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-646-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-646-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "DIANE",
        "middle_name": "MAROLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160003333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Izabella Brzoza
• Stephanie Bucz, RD
• Liz Buhai-Jacobus, PSY.D.
• Stephen Buhr, MSW, LCSW
• Sara Marie Buikema, LCSW
• Michael Bumroongsuk
• Susan Frances Burgess, DMD
• Mary G Burgos, O.D.
• Alyssa Christine Burns, MS, BCBA
• Florianne Pacheco Burns, OD

• Physical Therapy Assistant in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.