# PROTOCOL 1 REHAB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386321404
- **Authorized official:** DR. WILLIAM BOLSTER DC (OWNER)
- **Authorized official phone:** (630) 362-6055

## Contact information

- **Practice address:** 524 W 5TH AVE, NAPERVILLE, IL 60563-2901
- **Practice address phone:** (630) 362-6055
- **Mailing address:** 524 W 5TH AVE, NAPERVILLE, IL 60563-2901
- **Mailing address phone:** (630) 362-6055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251S0007X | Sports Physical Therapist | — | NULL | Yes |
| 2251S0007X | Sports Physical Therapist | — | — | Yes |
| 2251X0800X | Orthopedic Physical Therapist | — | NULL | — |
| 2251X0800X | Orthopedic Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 06/30/2023
- **Last updated:** 06/30/2023