Individual
ASHWINI VIVEK MODAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 W OGDEN AVE, HINSDALE, IL 60521-3158
(630) 325-9630
Mailing address
4507 W RIVERSIDE DR, PLAINFIELD, IL 60586-7537
(815) 575-4102
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-008975
IL
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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