MEDICARE: BIANCA VIRGINIA DILLON 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
1	225100000X	Physical Therapist	070.026921	IL
2	225100000X	Physical Therapist		IL

General Provider Information

NPI Number	:	1578288262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA VIRGINIA DILLON DPT

Provider Business Mailing Address
First Line	:	710 N STATE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3820
Country	:	US
Telephone Number	:	630-933-1500
Fax Number	:	630-933-1550

Provider Business Practice Location Address
First Line	:	710 N STATE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3820
Country	:	US
Telephone Number	:	630-933-1500
Fax Number	:	630-933-1550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2022
Last Update Date	:	02/03/2026

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