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NPI Code Detail

MEDICARE: NEAL CROSBY DEPERSIA JR. PT

MEDICARE:   NEAL CROSBY DEPERSIA JR. PT
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 Therapist070.013835IL

General Provider Information

NPI Number : 1346310927
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEAL CROSBY DEPERSIA JR. PT
Provider Business Mailing Address
First Line : 2300 N CHILDRENS PLZ
Second Line : BOX 142
City : CHICAGO
State : IL
Zip : 60614-3363
Country : US
Telephone Number : 773-327-2795
Fax Number :
Provider Business Practice Location Address
First Line : 4709 CREEKSTONE DR
Second Line :
City : DURHAM
State : NC
Zip : 27703-9822
Country : US
Telephone Number : 919-385-2647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 05/24/2023

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Directions to “ NEAL CROSBY DEPERSIA JR. PT” Practice Location

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