Individual
ALYSON R ENTWHISTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
80 TEMPLETON DR, OSWEGO, IL 60543
(630) 554-3456
(630) 551-2970
Mailing address
80 TEMPLETON DR, OSWEGO, IL 60543-7000
(630) 554-3456
(630) 551-2970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013107
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00882382
MEDICARE RAILROAD
IL
01
—
P00931542
MEDICARE RAILROAD
IL
Enumeration date
09/29/2006
Last updated
12/07/2021
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