Individual
CRYSTAL M ELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1323 BOND ST, SUITE 119, NAPERVILLE, IL 60563-2367
(630) 357-9699
(630) 357-9908
Mailing address
830 S ADDISON AVE, VILLA PARK, IL 60181-2877
(630) 620-4433
(630) 620-1148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070.005544
PT LICENSE
IL
Enumeration date
06/02/2010
Last updated
06/15/2010
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