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NPI Code Detail

MEDICARE: DIANE LIIGSOO PT

MEDICARE: DIANE LIIGSOO 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 TherapistIL

General Provider Information

NPI Number : 1659406890
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE LIIGSOO PT
Provider Business Mailing Address
First Line : 212 N BRIGHTON PL
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-6346
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3105 N WILKE RD STE H
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1450
Country : US
Telephone Number : 847-255-8690
Fax Number : 847-255-2260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/08/2007

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