Individual
ALFRED RAYMOND ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7315 W IRVING PARK RD, CHICAGO, IL 60634-3547
(773) 786-2340
(773) 589-0122
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070024499
IL
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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