Individual
WILLIAM HENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
471 W TERRA COTTA AVE, CRYSTAL LAKE, IL 60014-3434
(815) 526-0040
Mailing address
6533 MARBLE LN, CARPENTERSVILLE, IL 60110-2494
(217) 518-3852
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160009917
IL
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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