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NPI Code Detail

MEDICARE: MISS ELIZABETH SWANSON PT, DPT

MEDICARE: MISS ELIZABETH SWANSON PT, 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 Therapist070.023300IL

General Provider Information

NPI Number : 1356608871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELIZABETH SWANSON PT, DPT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD UNIT 102
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2222
Fax Number :
Provider Business Practice Location Address
First Line : 1010 EXECUTIVE DR STE 250
Second Line :
City : WESTMONT
State : IL
Zip : 60559-6137
Country : US
Telephone Number : 630-655-8785
Fax Number : 630-655-2759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2012
Last Update Date : 04/27/2018

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