Individual
BARI E ARDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5616 W 63RD ST, CHICAGO, IL 60638-5511
(773) 252-6227
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013187
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00931562
MEDICARE RAILROAD
IL
Enumeration date
10/02/2006
Last updated
07/14/2011
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