Organization
ELLIS PEDIATRIC PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIETTE ELLIS P.T. (PHYSICAL THERAPIST)
(847) 602-5016
Entity
Organization
Contact information
Practice address
310 HAPP RD STE 310, NORTHFIELD, IL 60093-3455
(847) 602-5016
Mailing address
433 OAKDALE AVE, GLENCOE, IL 60022-2112
(847) 602-5016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070008366
IL
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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