Individual
CONSTANCE H VANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
113 S EASTWOOD DR, WOODSTOCK, IL 60098-3519
(815) 334-0400
(815) 334-0800
Mailing address
113 S EASTWOOD DR, WOODSTOCK, IL 60098-3519
(815) 334-0400
(815) 334-0800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070004961
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS PROVIDER #
IL
01
—
367885100
US DEPT OF LABOR PROV #
IL
01
—
567700
MEDICARE GROUP NUMBER
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
01
—
568150
MEDICARE GROUP NUMBER
IL
01
—
DC7571
R R MEDICARE GRP #
IL
01
—
P00199532
R R MEDICARE PIN #
IL
Enumeration date
08/30/2006
Last updated
02/12/2016
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