Individual
ALESSANDRO MARCO ANTONINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
337 75TH ST, DARIEN, IL 60527
(630) 789-0004
(630) 789-0095
Mailing address
24014 W RENWICK RD, 2ND FLOOR SUITE F, PLAINFIELD, IL 60544-8708
(815) 577-2480
(815) 487-4550
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016012
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS GROUP #
IL
01
—
200852
MEDICARE GROUP #
IL
01
—
202542
MEDICARE GROUP #
IL
01
—
367885100
U.S. DEPT OF LABOR
IL
01
—
567770
MEDICARE GROUP #
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
Enumeration date
07/21/2006
Last updated
09/02/2008
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