Individual
DENISE STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
12112 S ROUTE 47, HUNTLEY, IL 60142-9619
(847) 802-5312
(847) 669-1859
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002881
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05632057
BLUE CROSS BLUE SHIELD
IL
01
—
601014700
ACS OWCP
IL
01
—
7515430
AETNA
—
Enumeration date
11/27/2007
Last updated
06/02/2016
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