Individual
MITCHELL TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
425 US ROUTE 30, SUITE 320, DYER, IN 46311
(219) 864-0290
(219) 864-0376
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216
(312) 640-0329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070002363
IL
Other
Enumeration date
02/08/2007
Last updated
11/23/2011
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