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NPI Code Detail

MEDICARE: MR. MARC THOMAS NEIDLINGER DPT

MEDICARE: MR. MARC THOMAS NEIDLINGER DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501017226MI
2225100000XPhysical Therapist070022985IL

General Provider Information

NPI Number : 1023472453
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARC THOMAS NEIDLINGER DPT
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number : 630-575-6250
Fax Number : 630-575-7450
Provider Business Practice Location Address
First Line : 24 S MORGAN ST STE 100
Second Line :
City : CHICAGO
State : IL
Zip : 60607-3668
Country : US
Telephone Number : 312-421-7274
Fax Number : 312-421-7289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2016
Last Update Date : 10/14/2024

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