Individual
ANDREW J CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS, FAAOMPT
Contact information
Practice address
951 MAIN ST STE 120, UNION GROVE, WI 53182-1074
(800) 974-4378
(630) 515-1536
Mailing address
24014 W RENWICK RD UNIT 206, PLAINFIELD, IL 60544-8711
(800) 974-4378
(630) 515-1536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5392-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40306500
—
WI
Enumeration date
07/24/2006
Last updated
02/20/2023
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