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Individual

MS. DIANE MARIE FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, PT

Contact information

Practice address
901 BIESTERFIELD RD, SUITE 306, ELK GROVE VILLAGE, IL 60007-3392
(847) 437-1230
(847) 437-9023
Mailing address
901 BIESTERFIELD RD, SUITE 306, ELK GROVE VILLAGE, IL 60007-3392
(847) 437-1230
(847) 437-9023

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070018604
IL

Other

Enumeration date
07/18/2011
Last updated
07/18/2011
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