Individual
DIANE NEWQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1213 S MAIN ST, ALGONQUIN, IL 60102-2741
(224) 505-3343
Mailing address
766 BUTTERNUT LN, ELGIN, IL 60123-2586
(847) 987-1627
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070005212
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS PROVIDER #
IL
01
—
367885100
U S DEPT OF LABOR PROV#
IL
01
—
567700
MEDICARE GROUP NUMBER
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
01
—
568150
MEDICARE GROUP NUMBER
IL
01
—
650022978
R R MEDICARE PIN #
IL
01
—
CJ4383
R R MEDICARE GROUP #
IL
01
—
CJ8115
R R MEDICARE GRP #
IL
01
—
P00221605
R R MEDICARE PIN #
IL
Enumeration date
08/30/2006
Last updated
03/28/2023
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