Individual
DUSTIN JODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
25445 S PHEASANT LN, UNIT H, CHANNAHON, IL 60410-8838
(815) 521-0111
(815) 521-0222
Mailing address
2414 W RENWICK RD, 2ND FLOOR, PLAINFIELD, IL 60544-0000
(312) 640-0329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-012130
PT STATE LICENSE #
IL
Enumeration date
01/03/2007
Last updated
06/27/2013
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